主动电极在超高龄患者永久心脏起搏治疗中的应用

Applications of active-fixation cardiac pacing leads in extreme elderly patients

目的观察主动心脏起搏电极在超高龄(≥90岁)患者中的应用特点。方法回顾性分析13例超高龄患者右房及右室心尖部主动起搏电极的使用情况,手术相关并发症的发生,如心肌穿孔、电极脱位、囊袋血肿或感染、术后心、肾功能变化等,以及术中即刻、术后1个月起搏参数的变化特点。结果术后1例患者心功能不全加重,其他患者无相关并发症发生;术后1个月随访起搏电极的阈值及阻抗低于术中即刻,差异有统计学意义(P<0.05)。结论主动电极在超高龄患者心脏起搏治疗中有效、安全,术中起搏阈值和阻抗明显升高,术后1个月逐渐下降。

Objective To investigate the characteristics of active-fixation pacing leads used among elderly patients over 90 years old.Methods The incidence of postoperative complications of 13 patients over 90 years old was observed,including myocardial perforation,electrode dislocation,pocket hematoma or infection,and postoperative cardiac or renal function.Electrode pacing parameters upon operation and 1 month after operation were recorded and analyzed.Results One case suffered from deteriorating cardiac function.No other complications were observed.The electrode pacing threshold value and impedance one month after operation were significantly lower than those upon operation(P<0.05).Conclusion Application of active-fixation pacing leads in extreme elderly patients is effective and safe.The pacing threshold value and impedance of active-fixation leads tend to increase perioperatively,but decrease gradually one month after operation.