【摘要】 目的:探讨心脏起搏器系统更换的原因和方法。方法:对73例起搏器系统更换患者的临床资料、电极参数、更换方式等作一分析。结果:脉冲发生器质保到期45例,电池自然耗竭24例,电池提前耗竭4例;60例更换同一模式起搏器,占82.2%,13例更换不同模式起搏器,占17.8%。80条电极中,留用电极51条(留用率63.75%),更换电极29条。更换电极的原因:起搏阈值过高17条(占58.6%),阻抗超范围2条,P波或R波振幅过低2条,电极与起搏器接口不匹配8条。71条电极术前程控测试和术中测试的电参数无明显差异。结论:起搏器系统更换主要原因是质保到期和电池耗竭;更换电极的主要原因为起搏阈值过高;术前程控测试电极参数对决定更换方法有重要指导意义。更多还原

【Abstract】 Objectives:To investigate the causes and methods of cardiac pacemaker replacement.Method:The clinical data,parameters of leads and methods of replacement in 73 patients undergoing cardiac pacemaker replacement were analysized.Result:Forty-five pacemakers reached lifetime expected,24 were depletion of battery naturally and 4 ahead of lifetime.The same mode pacemakers were replaced in 60 patients(82.2%)and different mode pacemaker in 13 ones(17.8%).51 leads were reused(63.75%)and 29 ones were disused.The causes of disused leads included extra-high threshold in 17 leads(58.6%),out of range of impedance in 2 ones and low amplitude of P or R wave in 2 ones,dismatching between lead and pacemaker in 8 ones.The parameters measured preoperation by programmer was similar to those measured during operation in 71 leads.Conclusion:The main causes of cardiac pacemaker replacement is lifetime expected and depletion of battery,that of disused leads is extra-high threshold.Measuring parameters before operation by programmer is very useful to decide the way of cardiac pacemaker replacement.更多还原