不同品牌埋藏式心脏转复除颤器植入术中起搏参数的对比研究

来源 :中国心脏起搏与心电生理杂志 | 被引量 : 0次 | 上传用户:hudaye1234
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目的探索不同品牌埋藏式心脏转复除颤器(ICD)测量R波、T波振幅和T/R比值有无差异及其与起搏器分析仪(PSA)测得R波振幅的差异和临床意义。方法 13例首次植入ICD或心脏再同步治疗-转复除颤器(CRTD)患者,术中先用PSA测量右室除颤电极导线稳定的起搏参数,再通过过桥线及一根普通的右室主动固定电极导线分别连接美敦力、波科、圣犹达、百多力公司的ICD演示器(DEMO,即未消毒的真机),分别测量R波振幅和电极阻抗并记录,打印出患者自主心律腔内图,手工测量R波及T波振幅并记录。结果 PSA与不同品牌ICD测量R波振幅有很好的一致性(协和系数=0.776),但仍有统计学差异(P<0.01)。与PSA相比,美敦力ICD测量R波振幅稍低(P=0.019)。但美敦力ICD测量T波振幅明显高于波科和百多力ICD(P=0.000)。美敦力ICD的T/R比值也明显高于其余三家公司ICD(P=0.000)。对于电极阻抗,PSA与不同品牌ICD测量值有很好的一致性(协和系数0.869),但也存在统计学差异。与PSA相比,圣犹达、百多力测得电极阻抗稍低(P=0.000和P=0.035)。结论 PSA与不同品牌ICD测量的波振幅及不同ICD间的T/R比值均存在差异。 Objective To explore the difference of R wave amplitude, T wave amplitude and T / R ratio measured by different brands of implanted cardioverter defibrillators (ICD) and their differences with R wave amplitudes measured by pacemaker analyzer (PSA) significance. Methods Thirteen patients with ICD or cardiac resynchronization therapy-defibrillator (CRTD) were implanted for the first time. The parameters of right ventricular defibrillation lead were measured with PSA before operation. Right ventricular active fixed electrode leads are connected to Medtronic, Poco, St. Jude, and BioDerm’s ICD Demonstrator (DEMO), respectively measuring R-wave amplitude and electrode impedance and recording Patients with independent heart rate lumen map, manual measurement of R wave and T wave amplitude and record. Results There was a good agreement between PSA and RCD amplitude measured by ICD (Coefficient = 0.776), but there was still a significant difference (P <0.01). Medtronic ICD measured R wave amplitude slightly lower (P = 0.019) than PSA. However, Tropsch amplitude measured by Medtronic ICD was significantly higher than that of Poco and Bioinductive ICDs (P = 0.000). Medtronic ICD T / R ratio was significantly higher than the other three companies ICD (P = 0.000). For the electrode impedance, PSA has good agreement with the ICD measurements of different brands (concordance coefficient 0.869), but there are also statistical differences. Compared with PSA, St. Jude, hundred resistance measured electrode impedance slightly lower (P = 0.000 and P = 0.035). Conclusion The wave amplitudes of PSA and ICD measured by different brands and the T / R ratio of different ICD are different.
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