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目的 评价 sp2 188电极及普通心室电极经冠状窦行左心房起搏的可行性和安全性。方法 16例患者 ,其中 9例选用 sp2 188电极 ,7例选用普通心室电极。所有患者均行左锁骨下静脉穿刺 ,X线采用正位或左前斜位植入冠状窦电极 ,寻找最佳的起搏和感知部位 ,同时高能量也不致心室夺获。结果 15例患者成功植入于冠状窦中、远端 ,术中起搏参数如下 (单极 ,脉宽 0 .5 4 m s) ,sp2 188电极组 :电压 ( 1.4 5± 1.4 5 ) V,感知 ( 4 .2 6± 0 .77) m V,阻抗 ( 5 0 5 .6±10 8.1) Ω;普通心室电极组 :电压 ( 1.4 3± 0 .91) V,感知 ( 3.93± 1.4 4 ) m V,阻抗 ( 4 6 8.3± 14 5 .1) Ω。两组起搏电压、感知、阻抗差异无显著性 ( P值均 >0 .0 5 )。随访 2～ 32 (平均 15 .0 )月 ,无一例死亡。其中 2例 sp2 188电极者发生脱位及微脱位 ,各有 1例 sp2 188电极者及普通心室电极发生起搏器介导性心动过速。最后一次随访结束 ,两组患者冠状窦电极起搏和感知功能均良好。结论 普通心室电极经冠状窦中、远端行左心房起搏可行、安全 ,且价格便宜 ,适合临床应用。
Objective To evaluate the feasibility and safety of sp2 188 electrodes and common ventricular electrodes in left atrial pacing via coronary sinus. Methods Sixteen patients, including 9 sp2 188 electrodes and 7 normal ventricular electrodes, were selected. All patients underwent left subclavian vein puncture. The X-ray was implanted into the coronary sinus electrodes with an anteroposterior or anterior left anterior oblique to find the optimal pacing and sensing sites. At the same time, the high energy did not cause ventricular seizure. Results Fifteen patients were successfully implanted in the distal and distal coronary sinus. The intraoperative pacing parameters were as follows (unipolar, pulse width 0.54 ms), sp2 188 electrode group: voltage (1.4 5 ± 1.4 5) V, (4.26 ± 0.77) mV, impedance (50.6 ± 10 8.1) Ω; normal ventricular electrode group: voltage (1.4 3 ± 0.91) V and sensation (3.93 ± 1.4 4) m V, Impedance (4 6 8.3 ± 14 5 .1) Ω. There was no significant difference in pacing voltage, sensory and impedance between the two groups (P> 0.05). Follow-up 2 ~ 32 (average 15.0) months, no one died. Two cases of sp2 188 electrode dislocation and micro-dislocation occurred in each of 1 cases of sp2 188 electrodes and ordinary ventricular electrode pacemaker-mediated tachycardia occurred. At the end of the last follow-up, both patients had good coronary sinus pacing and sensory function. Conclusion Common ventricular electrodes in the coronary sinus, distal left atrial pacing line feasible, safe, and cheap, suitable for clinical applications.