周菁,丁燕生,李康,盛琴慧,蒋捷,王禹川,史力斌

• 1:北京大学第一医院心内科

摘要(Abstract)：

目的初步探讨左室主动固定电极在心脏再同步治疗(CRT)中的应用价值。方法选取5例符合心脏再同步治疗适应证的心力衰竭(心衰)患者,在常规CRT植入技术基础上,左室电极选用美敦力主动固定电极Attain Star Fix4195,到位后伸展伞叶将其固定至目标血管位置,测试参数并检测有无膈肌刺激,随访观察有无膈肌刺激、脱位、阈值明显增高及心功能改善情况。结果 5例心衰患者全部手术成功。靶目标血管分别为心侧静脉2例,心后侧静脉1例,心中静脉2例。起搏阈值为(1.3±0.7)V,R波幅度(7.9±2.9)mV。术后1周超声心动图与术前比较:左室舒张末内径(LVDd)由(7.43±0.87)cm下降为(7.15±0.76)cm,左室射血分数(LVEF)由(28.8±2.8)%上升为(36.0±4.0)%,肺动脉压(PAPs)由(51.0±20.6)mm Hg下降为(24.6±2.6)mm Hg,二尖瓣反流均有不同程度减轻。术后6～16个月随访:NYHA分级4例患者由Ⅲ级下降为Ⅱ级,1例患者由Ⅳ级下降为Ⅲ级,均无脱位和膈肌刺激出现。结论 CRT采用左室主动固定电极安全性好,降低脱位和膈肌刺激风险,增加手术成功率。

关键词(KeyWords)： 电生理学技术,心脏心力衰竭;电极,植入

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 周菁,丁燕生,李康,盛琴慧,蒋捷,王禹川,史力斌

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