Kappa 700型双腔起搏器的临床随访

Clinical Oberservation of Dual Chamber Pacemaker With Ventricular Autocapture Function

观察具有自动夺获功能的双腔起搏器 (Kappa 70 0 )置入后参数的变化和安全性情况。随访 1 3例置入Kappa70 0型起搏器患者 ,观察术中、术后 1周及术后 1 ,3,6个月心室起搏阈值、输出电压、输出脉宽、电极阻抗、R波振幅的变化 ,了解起搏器的工作情况。术后测得的起搏阈值较术中明显升高 ( 0 .71± 0 .2 3Vvs 0 .39± 0 .0 6V ,P <0 .0 5 ) ,术后不同时间测得的起搏阈值无明显差异。R波振幅术中、术后无明显差异。术后阻抗较术中明显降低 ( 62 5 .7± 1 2 3.0Ωvs 894.3± 1 90 .3Ω ,P <0 .0 5 ) ,术后 1个月后的阻抗基本稳定。起搏器自动夺获功能打开后 ,平均输出电压为 0 .96～ 1 .1 6V ,平均输出脉宽 0 .32～ 0 .34ms,平均心房感知灵敏度 0 .71～ 0 .83mV ,心室感知灵敏度 3.82～3.91mV。随访期间起搏、感知功能正常 ,无误感知现象。具有自动夺获功能的双腔起搏器输出电压低 ,安全可靠。

To observe the changing parameters and the safety of dual chamber pacemaker with ventricular autocapture function, ventricular stimulation threshold, output amplitude, impedance, R wave amplitude, and the status of pacemaker were measured in the thirteen patients implanted Medtronic Kappa 700 at the time of implantation and 1st week, 1st months, 3rd months, 6th months after implantation. Six patients had ambulatory electrocardiographic records in the three months after implantation. The ventricular pacing threshold increased significantly after implantation(0.71±0.23 V vs 0.39 ±0.06 V , P <0.05), and did not any change during follow up. R wave had no change. The impedence decreased significently after implantation(625.7±123.0 Ω vs 894.3±190.3 Ω, P <0.05), there were no difference after 1st months. The mean output amplitude was 0.96-1.16 V, output amplitude 0.32-0.34 ms, atrial sensitivity 0.71-0.83 mV, ventricular sensitivity 3.82 -3.91 mV. All pacemaker worked effectively and safely during follow up for 7-31months. The result suggest that the dual chamber pacemaker with ventricular autocapture function could safely work with low output amplitude.