单根电极导线心室起搏双腔感知双反应方式起搏器远期效果分析

VDD Pacemaker in an Unipolar Lead for Clinical Practice

目的 探讨单根电极导线心室起搏双腔感知双反应方式起搏器 (VDD起搏器 )的远期临床使用效果。方法 1993- 0 3～ 2 0 0 2 - 0 5共植入单根电极导线的VDD起搏器 16例 ,其中男性 12例 ,女性 4例 ,年龄 4 9～ 75岁 ,平均年龄 ( 6 4 4± 7 8)岁。均为窦性心律正常伴完全性房室传导阻滞或高度房室传导阻滞者。常规采用穿刺锁骨下静脉方法植入电极导线 ,起搏器植入电极导线插入的同侧。结果 随访时间 112～ 1个月 ,平均 ( 6 8 8±6 3)个月。全部患者植入后 ,心功能提高 ,临床症状消失 ,长期随访生活质量明显改善 ,无心房感知不良者。 1例因冠心病合并心衰于随访 4 2个月死亡外 ,其余均健在 ,无失访者。结论 只要适应证选择合适 ,使用VDD起搏器手术简单易于操作 ,又可减轻病人负担并能取得最佳的治疗效果 ,心内科同道应重视这类起搏器的选用 。

Objective To inquire into the forward clinical results of ventricular pacing, dual-chamber sensing, atrial-triggered, and ventricular-inhibited (VDD) Pacemaker in an unipolar lead.Methods 16 patients with the pacemaker were studied from 1993 to 2002, including 12 male patients and 4 female patients at 49 to 75 years old (average age 64 4 7 8 years old). They were in normal sinus rhythmia with complete or high degree atrial-ventricular block. Lead electrode was inserted through subclavian venous access, and the pacemaker was implanted in the same side as the electrode.Results All patients were followed up from 1 to 112 months (average 68 8 6 3 months) after pacemaker implantation. Their heart functions were improved, symptoms disappeared, life quality remarkably improved. Atrial sensing of VDD was good. One patient was died from coronary heart disease with heart failure by following up for 42 months, but the rest were healthy. Conclusions VDD pacemaker implantation was simple, easy to perform if its indication was appropriate. It could alleviate patients symptom and its therapy was effective. We should think highly of using VDD pacemaker, especially at poor region.