【摘要】 目的:观察右室流出道(RVOT)间隔部和心尖部(RVA)植入起搏电极导线的可操作特性和电参数异同。方法:259例患者按起搏部位分为RVOT起搏组(148例)和RVA起搏组(111例),评价术中、术后1个月及6个月起搏参数及并发症情况。结果:术中、术后1个月及6个月的起搏阈值、电极阻抗在两组间差别均无统计学意义,RVOT起搏组1个月及6个月感知阈值高于RVA起搏组,术中两组间无差别;100%起搏QRS波时限RVA起搏组明显长于RVOT起搏组;两组手术时间及曝光时间无差别;与RVA起搏明显不同,RVOT间隔部的电极导线固定后张力不受膈肌运动的影响;导线螺旋旋出后,提拉电极导线呈接近"L"型,起搏无脱失、电极导线不脱落及心内膜图ST段抬高比旋前大于3 mV是其固定牢固的指标。结论:RVOT间隔部起搏电极导线有良好的可操作特性,短期随访电极导线固定牢固、电参数稳定。更多还原

【Abstract】 Objective: To observe maneuverability and electrical parameters of the ventricular leads at right ventricular outflow tract(RVOT) septal and apical position.Methods: 259 patients enrolled were divided into two groups:RVOT septal pacing group(n=148) and right ventricular apical(RVA) pacing group(n=111).The pacing parameters and complications were compared between the two groups with different pacing sites at implant,one month and six months after the operations.Results: No significant difference were found in acute implant measurement or the pacing parameters at one month and six months after the operations between the two groups,except that the sensing thresholds were significantly higher in RVOT pacing group than those in RVA pacing group one month and six months after the operations.And neither were in the procedure time on the time of exposing X-ray of the two groups.After 100% pacing,the mean QRS duration in RVA pacing group was significantly longer as compared to RVOT septal pacing group.In RVOT septal pacing group,no tension was discovered on the pacing leads in the heart chambers when the diaphragmatic muscle moved,which was different from RVA pacing group.After the pacing leads were fixed on the cardiac wall using a built-in screw,the pacing leads were pulled to form an"L" shape.Furthermore good capture,pacing leads not dropping,and ST segment elevation of at least 3 mV compared to baseline in the intracardiac electrocardiogram confirmed reliable fixation.Conclusion: This study conforms that the leads implanted in the RVOT septal position have good maneuverability,excellent electrical stability,and fixation of the pacing leads are reliable during the short-term follow-up.更多还原