主动固定电极对心脏起搏器置入术患者心室起搏参数的影响

Effect of Active Fixed Electrodes on Ventricular Pacing Parameters in Patients Undergoing Pacemaker Placement

目的探讨与分析主动固定电极对心脏起搏器置入术患者心室起搏参数的影响。方法选择2020年1月—2023年4月新疆生产建设兵团第二师库尔勒医院收治的需安置埋藏式心脏起搏器的85例患者作为研究对象,根据随机掷骰子原则把85例患者分为主动组(43例)与被动组(42例)。主动组采用主动固定电极行右室流出道间隔部、希氏束起搏治疗,被动组采用被动固定电极行右室心尖部起搏治疗,记录与观察两组心室起搏参数变化情况。结果主动组起搏器置入即刻的心室起搏参数起搏阈值、阻抗、P波幅度、电流均明显低于被动组,差异有统计学意义(P<0.05)。主动组电极置入时间、曝光时间均长于被动组,差异有统计学意义(P<0.05)。主动组电极置入后7 d起搏系统感染、下肢深静脉血栓、起搏电极脱位、起搏功能障碍等并发症发生率明显低于被动组,差异有统计学意义(P<0.05)。主动组的下肢制动时间、住院时间、临时心脏起搏电极留置时间均短于被动组,差异有统计学意义(P<0.05)。结论主动固定电极在心脏起搏器置入术患者中的应用能改善其心室起搏参数,增加患者的电极置入时间、曝光时间,减少右心尖起搏带来的心室非同步的电激动,降低患者的并发症发生率,改善患者的总体预后。

Objective To explore and analysis the eff ects of active fi xed electrodes on ventricular pacing parameters in patients undergoing pacemaker implantation.Methods A total of 85 cases of patients who were admitted to Korla Hospital of the Second Division of Xinjiang Production and Construction Corps from January 2020 to April 2023 and required the placement of an implantable pacemaker were selected as the research subjects.Accorded to the random dice principle,85 patients were divided into the active group of 43 cases and the passive group of 42 cases.The active group were treated with right ventricular outfl ow tract septum and Higgins bundle pacing using active fi xation electrodes,while the passive group were treated with right ventricular apical pacing using passive fi xation electrodes.The changes in ventricular pacing parameters were recorded and observed in both groups.Results The ventricular pacing parameters-pacing threshold,impedance,and P-wave amplitude immediately after pacemaker implantation in the active group were significantly lower than those in the passive group(P<0.05),and the current were signifi cantly reduced compared to the passive group(P<0.05).The electrode placement time and exposure time of the active group were signifi cantly increased compared to the passive group(P<0.05).The incidence of pacemaker system infection,lower limb deep vein thrombosis,pacemaker electrode dislocation,pacemaker dysfunction and other complications were 2.33%in the active group and 19.05%in the passive group 7 days after electrode implantation,which were signifi cantly lower in the active group than in the passive group(P<0.05).The lower limb immobilization time,hospitalization time,and temporary cardiac pacing electrode retention time in the active group were significantly reduced compared to the passive group(P<0.05).Conclusion The application of actively fi xation electrodes in patients undergoing pacemaker implantation can improve ventricular pacing parameters,increase electrode insertion time and exposure time,reduce ventricular asynchronous electrical stimulation caused by right apex pacing,reduce the incidence of complications,and improve the overall prognosis of patients.