左室主动固定电极在心脏再同步化治疗中的临床应用

Clinical Application of an Active Fixation Coronary Sinus Lead on Cardiac Resynchronization Therapy

目的:探讨左室主动固定电极在心脏再同步化治疗(cardiac resynchronization therapy,CRT)中的作用并总结其临床经验。方法:收集2008年1月至2013年1月由梅州市人民医院心内科植入CRT的患者,共56例(男34例,女22例)。根据植入冠状窦电极的不同,分为左室主动固定电极组(17例)和被动电极组(39例),观察和比较两组的手术时间、透视时间和造影剂用量。结果:左室主动固定电极组的手术时间[(61±36)min vs(143±61)min,P=0.035]和透视时间[(10±5)min vs(45±11)min,P=0.042]均较被动电极组显著缩短,而造影剂用量[(36±20)ml vs(87±46)ml,P=0.041]也较被动电极组明显减少。结论:左室主动固定电极用于心脏再同步化治疗可明显缩短手术时间,降低造影剂用量,使患者和术者均获益。

Objective： To investigate the effect of an active fixation coronary sinus lead on cardiac resynchronization therapy （CRT） and summarize the clinical experience. Methods： A total number of 56 patients （male 34, female 22）were implanted with CRT in Meizhou People＇s Hospital during January 2008 to January 2013. Leads were categorized into two different groups on the basis of their fixation mechanism： active fixation electrode（n=l 7）and passive electrode（n=39）. The operative time, fluoroscopy time and contrast agent dosage were observed and compared between two groups. Results： The operative time[（61＋ 36）rain vs （143＋ 61）min,P=0.035] and fluo- roscopy time[（10＋ 5）min vs （45＋ 11）min,P=0.042] of active fixation electrode group were significantly shorter than those of the passive electrode group, and the contrast agent dosage [（36± 20）ml vs （87± 46）ml,P=0.041] of active fixation electrode group was markedly lower than that of the passive electrode group. Conclusion： Active fixation coronary sinus lead could significantly shorten the operation time, reduce the amount of contrast media in the CRT. Patients and surgeons were all benefit from it.