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目的探讨Select Secure 3830电极房间隔起搏的有效性和可行性。方法 56例置入永久性人工心脏双腔起搏器的患者,依据患者心房电极导线的选择分为两组,其中置入美敦力3830心房螺旋电极共30例为观察组,同期置入美敦力4574心房翼状电极共26例为对照组,两组患者心室均置入3830心室螺旋电极,并于术前完善心电图、超声心动图、胸部正位片等检查。分别记录两组置入即刻、术后1个月、术后3个月、术后个6月心房电极起搏阈值电压、感知电压、阻抗,术后卧床时间,术前及术后6月左房内径大小等各项指标进行分析比较。结果入组患者均按计划成功行心脏双腔起搏器置入术,随访期间无死亡病例,未发生电极脱位、心脏穿孔、心包积液、囊袋感染等并发症。置入即刻,观察组心房电极起搏阈值电压明显高于对照组(P <0. 05),术后1个月、3个月、6个月两组起搏阈值电压无统计学差别(P均>0. 05);观察组术后1个月、3个月、6个月心房电极起搏阈值电压均低于置入即刻。观察组置入即刻、术后1个月、3个月、6个月测得阻抗低于对照组(P均<0. 05)。两组置入即刻、术后1个月、3个月、6个月心房电极感知电压参数无统计学差异(P均> 0. 05)。相较对照组,观察组患者术后卧床时间明显缩短,且术后6个月所测左房内径数值明显小于同期对照组,两者差别具有统计学意义(P均<0. 05)。结论Select Secure 3830电极在心房起搏的应用中安全有效,且能灵活地选择起搏位点,更符合生理传导模式,适合在临床工作中进一步推广应用。 [ABSTRACT FROM AUTHOR]

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