Zephyr5826起搏器心室自动阈值管理的临床观察(1)
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[摘要]目的 动态观察Zephyr5826起搏器心室自动阈值管理(ventricular capture mana- gement,VCM)功能在双极起搏、双极感知设置下的临床应用情况。方法 选取植入Zephyr5826起搏器患者73例，设置心室电极为双极感知、双极起搏，术后第1、7天及1、2、3、6个月时随访程控，观察VCM功能的开启情况,手工测试心室起搏阈值并与VCM功能测定的值进行比较。结果 69例随访半年，另4例随访3个月。随访期内73例均于术后第1天成功开启VCM功能。手工测试与VCM测试的心室阈值比较无明显差异。随访期间心电图及动态心电图(Holter)均未见心室失夺获及感知不良。结论Zephyr5826起搏器VCM功能在双极起搏、双极感知设置下可以安全有效的应用低能量起搏心脏。
关键词：心血管病学起搏器 起搏阈值 自动阈值测试心室阈值管理
The clinical observation of the ventricular capture management in Zephyr5826 pacemaker. SI Hai-long,LIN Wen-hua,ZHANG Feng,WANG Xiao-dong, LIU Jing-jing，REN Zi-wen.The 11th Ward,TEDA International Cardiovascular Hospital,Tianjin Medical University, postalcode 300457,Tianjin,China.
[Abstract] ObjectiveTo observe the effect of the ventricular capture management (VCM) in Zephyr5826 pacemaker with bipolar pacing and bipolar sensing.Methods73 patients were implanted Zephyr5826 pacemaker with bipolar pacing and bipolar sensing.Observe the operation of VCM function and compare the ventricular thresholds tested manually with that tested by VCM function at the time of 1 day，7 days，1 month，2 months，3 months and 6 months after implantation.Results69 patients finished the follow-up of 6 months,and other 4 patients finished the follow-up of 3 months.All the patients’VCM function were turned on at the time of 1 day after implantation. The ventricular thresholds tested by VCM function have no statistical significant difference with the thresholds tested manually.The ECG and Holter monitoring in all patients showed a normal pacing function without loss of cap- ture. ConclusionTesting the threshold and reducing the energy output antoma- tically by VCM function are effective and safe in Zephyr5826 pacemaker with bipolar pacing and bipolar sensing.
[Key words] Cardiology；Pacemaker；Pacing threshold；Auto capture management；automatic threshold measurement；ventricular capture management
中图分类号：R714.252文献标识码：B文章编号： 1004-7484(2011)05-0081-02
1995年，St.Jude公司将具有心室自动阈值管理(ventricular capture management,VCM)功能的单腔起搏器Microny成功上市，开启了VCM功能起搏器的临床应用及进一步研究的新局面[1]。在VCM功能测试心室阈值时，为了提高对刺激除极波(Evoked Response，ER)的感知，心室电极一般设置为单极起搏、双极感知 ......
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