关键词：心内膜电极导线；病理形态学；心功能
【摘要】 目的 通过动物实验观察心脏起搏电极的电性能和病理形态学变化,以供临床应用时参考。 方法 将一对电极导线植入犬的右室心尖部后,定期测量电极的电参数和心功能,3个月后处死犬,进行形态和光镜病理检查。 结果 碳电极的起搏阈值和感知等电性能优于Elgiloy电极,且其组织反应小；两根电极导线植入后对心功能和三尖瓣关闭无明显影响;电极头与心肌组织间可见包绕性纤维团块,以纤维结缔组织增生和肉芽组织形成为主,伴少许浆细胞、单核细胞和淋巴细胞浸润。部分电极导线与腱索和三尖瓣环形成粘连。 结论 良好电性能的电极刺激阈值低,感知功能好,局部组织反应轻,有利于保护心功能;由于电极头与心肌间形成纤维包绕团块,故电极如需拔除,需应用专门器械。
Electrical performance and pathologic alteration of endocardial pacing lead electrode in dogs and its clinical significance SUN Weixin,MA Yi,LAN Yanping,et al.Xi′an Medical University,Xi′an 710061
【Abstract】 Objective To investigate the electrical performance and pathologic alterations of endocardial pacing lead electrodes in dogs and to evaluate their clinical significace. Methods The pacing threshold and sensing function were measured 1,2,3,4,6,8,10,and 12 weeks after both carbon and Elgiloy endocardial electrode leads were implanted into dogs right ventricular apex.The dogs were sacrificed 3 months after electrode implantation,and the local pathologic alterations were assessed both macroscopically and microscopically. Results After paired electrode leads implantation,neither cardiac malfunction nor tricuspid valve incompetency was observed in spite of that some fibrous adhesion occurred at the lead to chordae tendineae and tricuspid leaflet.There was fibrous encapsulation formed around the elctrode.Microscopically,it was fibrosis and granulomatous formation with minor plasma cell and lymphocyte infiltration.Lower stimulating threshold,better sensing function and milder tissue reaction were encountered at the carbon electrode than the Elgiloy electrode. Conclusion High quality electrode,which can result in lower pacing threshold,better sensing function and milder local tissue reaction,should be recommended for clinical use.Due to the presence of local fibrous encapsulation and adhesion,special devices should be used to extract a chronic lead if necessary.
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