自动阈值夺获和自动模式转换双腔起搏器的临床应用

Clinical Application of Autocapture and Aautomatic Mode Switch Function of Dual-chamber Pacemaker

目的 评价具有自动阈值夺获和自动模式转换功能的双腔起搏器的有效性及随访情况。方法 2 1例患者因病态窦房结综合征或Ⅲ度房室传导阻滞植入具有自动阈值夺获和自动模式转换功能的PacesetterENTITYTMModelDC 5 2 2 6型双腔起搏器 ,其中 15例有阵发性快速房性心律失常 ,随访 3月～ 2年 ,测试植入术中及术后的起搏阈值 ,阻抗 ,心室除极波 (evokedresponse ,ER) ,极化电位 ,术后 3d心电监护 ,结合EKG和HOLTER检查 ,回顾自动模式转换功能 (AMS)的启动情况。结果 除 1例外其余 2 0例自动阈值夺获 (autocapture,AC)功能运行良好。应用EKG ,HOLTER评价AMS工作情况 ,15例患者术后 3d 5 13次启动了自动模式转换 (automaticmodeswitch ,AMS)功能 ,总检测失败率为 4 .87% (2 6 / 5 34) ,误检率 0 .97% (5 / 5 13)。发现AMS功能误检率低 ,成功率高 ,安全可靠。结论 具有自动阈值夺获和自动模式转换功能的双腔起搏器安全 ,可靠 ,使用寿命长 。

Objective To assess the auto capture and automatic mode switch function of dual-chamber pacemaker.Methods 21 patient,suffered from sick sinus syndrome or Ⅲ0 AVB were implanted with auto capture and automatic mode switch dual-chamber pacemaker.The paroxysmal atrial tachyarrhythmia were found in 15 patients.During the period of 3～24 months' follow-up,pacing threshold,impedance,ER and polarized potential were tested.The EKG and HOLTER were performed to monitor tachyarrhyhmia.The efficacy of detective function of automatic mode switching pacemaker on paroxysmal atrial tachyarrhythmiawas was assessed.Results Auto capture function was turned on 20 patients with normal ER signal and polarized potential.15 cases had total 534 episodes of atrial tachyarrhythmia.516 episodes of atrial tachyarrhythmia were detected by pacemaker with activation of AMS.The detective failure rate of atrial tachyarrhythmia was 4.87%.Conclusion The pacemaker with auto capture and automatic mode switch function is safe and energy-saving.The automatic mode switching device may be more appropriate in patients with paroxysmal atrial tachyarrhythmia who need pacing therapy.