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目的比较右室主动固定电极和被动电极导线应用结果,探索右室主动固定电极导线临床应用的可行性。方法需要安置心脏起搏器患者59例,其中男20例、女39例;年龄在75.6±23.8(54~92)岁。患者为缓慢性心律失常或者严重心力衰竭。30例被动电极组,固定部位为右室心尖部;主动电极组29例,电极固定部位为右室流出道。结果主动电极组与被动电极组即刻起搏参数比较没有明显的差异(起搏阈值:0.62±0.19V vs0.78±0.09V,P>0.05)。在出院后1,3,6个月随访起搏阈值与置入时比较也没有差异。只有1例出现主动电极从右室流出道间隔部脱位。主动电极置入时间和曝光时间较被动电极明显延长(45.03±1.99min vs13.69±11.37min;17.88±7.23min vs9.78±3.55min,P均<0.05)。结论使用主动固定电极进行右室流出道间隔部起搏是可行和安全的。
Objective To compare the results of active electrode fixation with passive electrode in right ventricle and explore the feasibility of clinical application of active electrode fixation in right ventricle. Methods 59 patients with pacemakers were required, including 20 males and 39 females, with a mean age of 75.6 ± 23.8 (ranged from 54 to 92). Patients with bradyarrhythmia or severe heart failure. 30 cases of passive electrode group, the fixed part of the right ventricular apex; active electrode group of 29 cases, the electrode fixed part of the right ventricular outflow tract. Results There was no significant difference in immediate pacing parameters between active and passive electrodes (pacing threshold: 0.62 ± 0.19V vs 0.78 ± 0.09V, P> 0.05). There was no difference in pacing thresholds at 1, 3, and 6 months after discharge compared with those at implantation. In only 1 patient there was dislocation of the active electrode from the RV outflow tract septum. The active electrode placement time and exposure time were significantly longer than the passive electrode (45.03 ± 1.99min vs13.69 ± 11.37min; 17.88 ± 7.23min vs9.78 ± 3.55min, all P <0.05). Conclusion It is feasible and safe to use the active fixed electrodes for right ventricular outflow tract pacing.