双房单室三腔起搏器治疗病窦综合征并快速房性心律失常

The Clinical Effect of Three Chamber Biatrial Pacing in Patients of Atrial Tachycardia of Sinus Sick Syndrome.

观察双心房、单心室三腔起搏器治疗病窦综合征合并阵发性房性快速心律失常患者的疗效。三根电极导线分别置入冠状静脉窦内、右心耳和右室心尖部行三腔起搏。冠状窦电极导线与右心房电极导线通过一个Y型转接器构成心房部分。结果 :10例患者 ,9例经左锁骨下静脉径路置入导线 ,1例因存在残存左上腔静脉 ,从右锁骨下静脉置入。 10例中 9例冠状窦电极导线置于冠状静脉窦中部、1例置于冠状静脉窦远端。冠状窦起搏阈值为 1.0 6±0 .2 0V、起搏阻抗 6 11± 115 .8Ω、P波振幅为 4.0 7± 0 .88mV ;右室电极起搏阈值为 0 .5 3± 0 .12V、起搏阻抗 6 70 .3±191.7Ω、R波振幅为 9.6 6± 1.87mV。随访 5～ 2 4个月有 9例起搏器呈DDD工作方式 ,1例呈AAT工作方式。起搏和感知功能良好。 10例中 8例快速性房性心律失常完全控制 ,2例发作次数减少 ,持续时间明显缩短。无一例出现并发症。结论 :三腔起搏器技术安全、可靠。

To observe the clinical effect of three chamber biatrial pacing in patients with atrial tachycardia of sinus sick syndrome,three leads were inserted into coronary vein sinus,right auricle and apex of right ventricular,respectively.The coronary sinus leads with right atrium lead was connected by a 'Y'type convertor.Results:The pacing threshold of coronary sinus leads were 1.06±0.20;resistence were 611±115.8 Ω and the amplitude of P wave 4.07±0.88 mV,The pacing threshold of right ventricular leads were 0.53±0.12 V;the resistence were 670.3±191.7 Ω and the amplitude of R wave were 9.66±1.87 mV.The 9 patients were set DDD pacing mode and 1 patient AAT during 5～24 months follow up.8 of 10 patients with atrial tachycardia could be controled completely;the other 2 patients′ attack times and persistent times reduced markedly.There were no complication.Conclusion:The three chamber pacing could be applied safely to patients with atrial tachycardia of sinus sick syndrome.