【摘要】 目的:明确电极阻抗与起搏阈值的急性期至慢性期的变化过程,并与高阻抗电极进行比较,以证明高阻抗电极的效果。方法:所有电极在植入即刻使用起搏分析仪检测:起搏阈值,感知灵敏度(R波幅度),电极阻抗和电极电流。于术后12、24、72 h、1周、1月、3月、6月,以后每年1次,使用美敦力起搏程控器重新检测上述指标,其中为保证测得的起搏阈值可靠,采用固定电压测得的脉宽阈值,然后计算能量阈值。结果:电极阻抗在植入的12～24 h明显下降,起搏阈值升高,在3～6月后基本稳定;最佳植入阻抗在400Ω以下。高阻抗电极电极阻抗明显升高,起搏电流消耗下降,但长期观察,阻抗有下降趋势,电流消耗也升高。结论:密切监测电极阻抗可以真实的反应电极成熟过程,对电极的植入和电极脱位等并发症有明确指导价值。高阻抗电极对起搏电流的消耗有明确的减低作用,但远期效果有所减小。更多还原

【Abstract】 Objective:To observe fluctuate feature of the impedance and threshold at acute and chronic stage after implanting pacemaker leads and further comparing with the high impedance pacemaker leads.Methods:Lead impedance(Ω),sensing thresholds(mV),current(mA) and pacing thresholds(V) were mea-sured by pacemaker analyzer(Medtronic 6511 or Biotronic EPA) when pacemaker leads were implanted im-mediately and by telemeter at following period.Follow-up was performed on 12 hours,24 hours,72 hours,1 week,1 month,3 months,6 months,every 1 year,thereafter for 3-years post-implanted.At each visit,pac-ing thresholds were determined as pulse duration(ms) at 1.0 V and as the minimum charge for capture.Re-sults:The impedance of lead decreased obviously at 12～24 h after implanted,while the pacing threshold ascended and kept stability after 3-6 months.The optimum impedance was less than 400 Ω.The lead impedance was obviously higher in high-impedance lead,and the current of pacing decreased at the same time.But in long term following-up,the impedance showed a decreasing trend,while the current showed in-creasing in high-impedance lead.Conclusion:The lead impedance can respond really the pacemaker lead status,and is of gteat value on the the lead implanting and the lead dislocation.The high-impedance lead can decease the current of pacing consume,but the effect became less in the long-term observing.更多还原