【摘要】 目的 研究三维电场导航下零X线透视植入单腔及双腔起搏器的可行性。方法 选择5例严重心律失常需急诊植入永久起搏器的患者,在导管室X线机被其它手术占用的情况下,完全脱离X线植入起搏器。患者背部贴Ensite^TM参考电极,起搏电极建模,置入目标心腔位置,心房电极可直接固定,而心室电极再送入3⁵ cm,测试并确认电极稳定后缝扎固定,并连接起搏器。结果 在三维电场导航下,5例患者零X线透视成功植入单腔和双腔起搏器,X线曝光时间为0 min,平均手术时间分别为（51.3±13.1）min和（97.5±16.3）min,术后平均随访12个月,起搏器阈值检测正常。结论 三维电场导航植入单腔和双腔起搏器安全可行,适用于须避免X线辐射的特殊人群或X线机手术台被其他患者占用时。更多还原

【Abstract】 Objective To explore the feasibility and safety of non-fluoroscopic implantation of pacemaker guided by Ensite-NavX^TM.Methods Patients with severe bradycardia were arranged for zerofluoroscopic implantation of pacemaker guided by Ensite-NavX^TM when C-arm X-ray machine was being used for other procedures.We reconstructed the model of right atrium,right atrial appendage,and right ventricle with Ensite-NavX^TM.Subclavian vein was punctured.Atrial or ventricular leads were collected to three dimensional mapping system and cables for examining pacing parameters.The leads were placed into the target chambers.Ventricular leads were further advanced 3-5 cm after reaching the ideal position.Atrial leads or ventricular leads were fixed when the pacing parameters were still satisfactory after gendy inserting and retracting the leads.Results Five cases underwent implantation procedures guided by three-dimensional electro-anatomic mapping system and without X-ray.Three cases were implanted with single-chamber pacemaker and two cases with dual-chamber pacemaker.The total fluoroscopic time was 0 minute.The average procedure time was（51.3 ± 13.1） minutes and（97.5 ± 16.3） minutes for single-chamber and dual-chamber pacemakers,respectively.The pacing parameters were normal during follow up.Conclusion Single-chamber or dual-chamber pacemakers can be safely and effectively implanted under the guidance of three-dimensional electro-anatomic mapping system.Our method offered a choice for some special population who need to avoid radiation or in the occasion when X-ray machine is not useable.更多还原