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1、西北国防医学杂志(MedJNDFNC)2006Jun.;27(3)173#论著#起搏器更换时原起搏电极导线参数及更换指标分析张卫泽,马凌,胡静泠,秦勉,王艳春,张明旭,陈永清,杜修海(兰州军区兰州总医院心血管内科,甘肃兰州730050)摘要:目的:分析74例更换起搏器时电极导线的各项参数的变化并探讨导线更换指标。方法:本组年龄12~87(62.8?18.4)岁,其中病窦综合征45例,房室传导阻滞29例,均为单腔VVI起搏。结果:至测量时原心室起搏电极导线的埋置时间60~148(97.4?22.8)月,首次埋置时起搏
2、阈值为(0.48?0.24)V,更换时为(1.29?0.64)V(P﹤0.01),增加0.81V,增幅为168%,首次植入时R波幅为(7.8?3.6)mV,更换时为(5.9?3.4)mV(P﹤0.05)。植入时电极导线阻抗为(664?122)8,更换时阻抗为(726?148)8,增幅9.3%(P﹥0.05)。7例因起搏阈值大于2.0V或阻抗大于12508而重新植入电极导线。原电极导线使用率为90.5%。结论:埋置起搏电极导线8~9年后,90.5%原电极导线仍在可使用的范围内,能否支持到再次更换需进一步随访。关键词:
3、起搏器;起搏电极导线;起搏阈值;电极导线阻抗中图分类号:R541文献标识码:A文章编号:1007-8622(2006)03-00173-03AnalysisofrelatedparametersofimplantedventricularleadsduringtheprocessofpulsegeneratorreplacementandimplicationforleadsreplacementZHANGWei-ze,MALin,HUJing-ling,etal.(DepartmentofCardiology,L
4、anzhouGeneralHospita,lLanzhouCommand,PLA,Lanzhou700050,China)Abstract:Objective:Toanalyzetheparametersofimplantedventricularleadsin74patientsreceivingpulsegeneratorreplacement.Methods:Pulsegeneratorswerereplacedin74patients(male41andfemale33cases;meanage:62.8?
5、18.4years).Amongthe74patients,45weresicksinussyndromeand29weresecondtothirddegreeatrioventricularblock.AllofthepacingmodeswereVVI.Results:Implantedventricularleadshadbeenimplantedfor97.4?22.8(from58to179)monthsuntilpulsegeneratorswerereplaced.Theinitialpacingt
6、hresholdofleadswas(0.48?0.24)V.Onthetimetoreplacepulsegenerator,thethresholdincreasedby168%andreached(1.29?0.64)V,(P<0.01)withthemeanincreasevalueof0.81V.Comparedwiththeinitialparameters,Rwaveamplitudedecreasedsignificantlyduringpulsegeneratorreplacement(7.8?3
7、.6)mVvs(5.9?3.4)mV,(P<0.05).Theleadimpedanceshadnosignificantchangecomparedtoinitialimpedance(726?148)8vs(664?122)8,(P>0.05).Newleadswereimplantedin7patientsduetotheoriginalleadthresholdover2.0Vorimpedanceover12508.Sixty-seven(90.5%)oldleadswerecontinuedtoperf
8、ormthepacingfunction.Conclusion:Relatedparametersof90.5%leadswerenormalwithin8to9yearsafterimplantingventricularleads.Thefollow-upshouldbetakentojudgewhetherthesecondleadreplacemen
