埋藏式心脏起搏器术后起搏阈值的动态变化

目的:观察埋藏式心脏起搏器术后电极成熟期前后起搏阈值的变化规律。方法:对30例接受埋藏式心脏起搏治疗的患者分别于术中、术后1周、2周、1个月、2个月、3个月、6个月测定起搏阈值。结果:16例应用Medtronic CAPSURESP系列(激素洗提)心房电极的患者心房起搏阈值术后升高,本后1周达峰值,后逐渐降低,术后2个月开始趋于稳定,除术后6个月外,其余各时间点与术中比较差异均有非常显著性(P<0.01);24例应用MCSP系列心室电极的患者心室起搏阚值术后均明显高于术中(P<0.01);9例应用BIOTRONIK SYNOX SX系列(高阻抗非激素洗提)电极的患者心房、心室平均起搏阈值具有与MCSP系列起搏电极类似的术后演变趋势.其急性期起搏阈值呈明显峰化现象,且具有较高的慢性期阚值,与40条MCSP系列电极比较,两者急、慢性期起搏阈值差异均有非常显著性(P<0.01)。结论:埋藏式心脏起搏器术后6个月内,起搏阈值明显升高;激素洗提电极能明显降低急性期和慢性期阚值。

Dynamic change of pacing threshold after cardiac pacemaker implantation

Objective: To observe the dynamic change of pacing threshold after cardiac pacemaker implantation. Methods: Pacing threshold was measured in 30 patients undergoing implantable cardiac pacemaker at implant, at 1 and 2 weeks, and 1,2.3 and 6 months after implantation. Results: Compared with at implant, the mean pacing threshold increased remarkably after operation in 16 patients implanted with steroid-eluting Medtronic CAPSURESP (MCSP) atrial leads (other than 6 months) and 24 with ventricular leads (P<0. 01): it peaked at 1 week, decreased thereafter, and tended to be stable in 2 months. Although the mean pacing threshold was higher in 9 patients receiving high-impedance, nonsteroid-eluting BIOTRONIK SYNOX SX (BSSX) lead implantation than that in subjects implanted with MCSP leads (P<0. 01), both presented a similar trend of post-implantation change. Conclusion: The increase of pacing threshold is obvious within 6 months after pacemaker implantation. Steroid-eluting leads are able to decrease the pacing threshold in a-cute and chronic stages.