病窦综合征患者起搏器植入中应用主动电极11例临床研究

Pacemaker implantation in patients with sick sinus syndrome:a case of 11 patients with active electrode

目的 :探讨病窦综合征患者起搏器植入术中应用主动固定起搏电极导线的效果。方法:收集病窦综合征患者11例,入院后均接受起搏器植入术治疗,手术在X线指导下均采用主动固定起搏电极导线置入目标区域。术后随访12个月,观察主动固定起搏电极导线的植入稳定性和并发症发生情况,采用起搏系统分析器测量本组患者植入即刻、术后3个月、术后6个月、术后12个月的起搏阈值、振幅和阻抗参数变化,胸片复查观察心功能变化和主动固定起搏电极导线有无移位等。结果:11例患者手术均成功植入起搏器和主动固定电极导线,术后和随访6个月稳定性、安全性较高;术后3个月、6个月、12个月起搏阈值、阻抗参数均明显低于手术植入即刻,差异具有统计学意义(P<0.05),术后各时点参数较为稳定,相较差异无统计学意义(P>0.05);随访6个月期末患者心功能指标LAD、RAD、LVEDd、RVEDd较术前均有显著下降,差异具有统计学意义(P<0.05)。结论:病窦综合征患者起搏器植入术中应用主动固定电极导线是安全可行的,术后起搏参数较为稳定,有利于心功能预后恢复。

Objective:To investigate the effect of active fixation pacing lead in pacemaker implantation in patients with sick sinus syndrome.Methods:11 cases of sick sinus syndrome patients as the research object,received pacemaker implantation after admission,surgery adopts active fixation pacing electrode was implanted in the target region in X-ray guidance.After 12 months of follow-up,observation of implant stability of active fixation pacing leads and complications,the pacing system analyzer in this group of patients implanted immediately,3 months after surgery,6 months after surgery,12 months after surgery,the pacing threshold and impedance parameters,amplitude variation,chest X-ray examination to observe the cardiac function change and active fixation pacing lead had no shift etc.Results:11 cases were successfully treated with pacemaker implantation and active fixation electrode wire,high safety and stability of 6 months after surgery and follow-up;after 3 months,6 months,12 months,pacing threshold and impedance parameters were significantly lower than surgical implantation immediately,the difference was statistically significant(P<0.05),after the operation time parameter was relatively stable,with no significant difference(P>0.05);6 months follow-up period of cardiac function in patients with LAD,RAD,LVEDd index and RVEDd were significantly decreased compared with preoperative,the difference was statistically significant(P<0.05).Conclusion:It is safe and feasible to use the active fixation lead in the pacemaker implantation in patients with sick sinus syndrome,and the pacing parameters are stable after operation,which is beneficial to the recovery of cardiac function.