主动固定起搏导线的临床应用易桂斌殷泉忠陆叶李健张华崔俊友东南.DOCVIP

通讯作者：崔俊友，E-mail：jycjy@ 主动固定起搏导线的临床应用 易桂斌 殷泉忠 陆叶 李健 张华 崔俊友 东南大学附属江阴医院心内科,江苏省,214400 【摘要】 目的：观察Medtronic 3830主动固定导线在临床心脏起搏治疗的可行性、安全性。方法：40例需起搏器植入的患者，随机分为3830导线组（A组，n=20）和Medtronic 5076普通螺旋导线组（B组，n=20），采用VVI或DDD起搏模式，心室导线均放置在右室间隔部（RVS），观察两组在术中及术后的各项心室导线参数以及有无并发症。结果：两组患者均顺利完成手术，均无术后发生导线脱位或穿孔。A组术后并发肺栓塞2例， 且该组手术X 线曝光时间明显延长(10.8±4.4vs7.3±2.8min, P 0. 01)；术中及术后1 月、3月两组的心室起搏阈值、阻抗、R波振幅比较无显著差异。结论：Medtronic3830导线用于选择右室间隔部起搏是可行的，但应该谨慎选择。 【关键词】心脏起搏；主动导线；3830 Clinical Application of Medtronic3830 Active-fixation Lead Yi Gui-bin, Yin Quan-zhong, Lu Ye, Li jian，Zhang Hua, Cui Jun-you Department of Cardiology, Jiangyin Hospital Affiliated to Medical College of Southeast University, 【Abstract】 Objective To investigate the feasibility and safety of Medtronic3830 active-fixation leads with ventricular pacing. Methods Forty patients with pacemaker implantation indication were randomized into two groups. One group underwent ventricular pacing with Medtronic3830 active-fixation leads (Group A), and the other with Medtronic 5076 active fixation leads (Group B)，regardless the type of atrial leads. All active fixation leads were localized at right ventricular septum, with VVI or DDD modes. The pamameters of two groups were recorded during and after procedure and compared accordingly. Results Prodedures in two groups came off smoothly and there were no subjects with lead dislocation or perforation. There were 2 patients with pulmonary embolism in Group A, expose time was longer in which group (10.8±4.4vs7.3±2.8min, P 0. 01). There was no significant difference in pacing threshold, impedance and sensation between two groups during procedure and 1 month or 3 months after the procedure. Conclusions It is feasible to pace from right ventricular septum with Medtronic3830 active lead, if a careful choice is made. 【Key words】Pacing; Active fixation lead; Medtronic3830 随着生理性起搏的概念逐渐深入人心，能够提供选择部位起搏的主动导线在临床获得越来越普遍的使用；而Medtronic3830导线是美敦力公司近年来在国内刚上市的目前最细的实心双极主动固定导线，有59cm、69cm、74cm长三种规格，根据身高和心脏大小选择