食管导电球囊电极导管的研制与应用

A Clinical Study of Novel Electric Balloon Electrode Catheter for Transesophageal Ventricular Pacing

因普通金属环电极在食管内较难定位心室部位 ,而且起搏阈值高 ,检查时病人痛苦较大 ,限制了经食管心室起搏的临床应用。为探讨一种低阈值、简单易行的经食管心室起搏方法 ,笔者自行设计研制了一种经食管心室起搏导电球囊电极导管。该导电球囊电极经抽、充气可使球囊瘪缩或膨胀 ,以利于球囊导管自鼻孔插入或拔出。导电球囊经充气后膨胀 ,其导电面积较金属环电极增大 5 0倍 ,这有利于降低起搏阈值。笔者对 5 8例受检者同时应用普通金属环电极导管与导电球囊电极导管进行经食管心室起搏。结果 :应用金属环电极导管只有 41例完成检查 ,而导电球囊电极导管有 5 6例顺利完成经食管心室起搏检查 ,其成功率分别为 68.3%与 96.5 % ,心室起搏阈值分别为 38.67± 1 .2 8V和 2 5 .2 7± 3.69V ;两者相比 ,差异有显著性 (P均 <0 .0 5 )。结论 :该导电球囊具有导电面积大 ,与食管接触良好 ,易于在食管内定位起搏心室。与普通金属环电极导管比较 ,具有起搏阈值低、成功率高 ,病人痛苦小等优点 。

In order to decrease pacing threshold and raise success rate during transesophageal ventricular pacing, a novel electric balloon electrode catheter was designed and made. The electric balloon electrode could be expanded by filling gas and the area of expanded electric balloon electrode had 22cm 2. 58 patients were performed transesophagal ventricular pacing by the usual metallic ring electrode and the electric balloon electric balloon electrode catheter.Their success rate of ventrical pacing and ventricular pacing threshold were compared.Results:There were a significant differences in the success rate of ventricular pacing (68.3% vs 96.5%, P <0.05) and in ventricular pacing threshold (38.67±1.28 V vs 25.27±3.69 V, P <0.05).The patients had less or no clinic syndrome during using the electic balloon electric balloon.Conclusion:Compared with the usual electrode catheter,balloon electrode catheter are of lower pacing threshold,higher success rate,lesser pain.and it could be widely adopted in the clinic.