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目的:探讨心脏起搏器置入术中心房颤动(房颤)发作时置入心房电极的方法和可靠性。方法:对24例具有心脏起搏器安置指征的慢快综合征患者房颤发作时置入心房电极的方法、术中术后心房电极的参数进行分析。结果:所有病例全部成功置入心房电极。4例阵发性心房扑动(房扑)患者经超速刺激转复2例;普罗帕酮转复8例阵发性房颤、房扑患者4例成功,胺碘酮转复14例阵发性房颤患者6例成功,总转复率45%。12例术后复律后程控测得P波振幅、心房电极阻抗、起搏阈值与12例术中复律患者测得的参数差异无统计学意义(P>0.05);10例房颤患者术中测得心房波为(0.8±0.6)mV,明显小于术后复律后程控测得的P波(1.4±0.5)mV(P<0.05),但两者阻抗无明显差别(P>0.05)。结论:心脏起搏器置入术中房颤发作时置入心房电极安全可靠。
Objective: To investigate the method and reliability of atrial pacemaker implantation during atrial fibrillation (AF). Methods: Atrial electrode placement was performed in 24 patients with slow syndrome with pacemaker placement. The parameters of postoperative atrial electrode were analyzed. Results: All cases were successfully inserted into the atrial electrode. In 4 patients with paroxysmal atrial flutter (atrial flutter), 2 patients were recovered by overstimulation, propafenone 8 patients with paroxysmal atrial fibrillation, 4 patients with atrial flutter were successfully treated, and amiodarone reversed 14 patients Six patients with atrial fibrillation were successful, with a total conversion rate of 45%. There was no significant difference in P wave amplitudes, atrial electrode impedance, pacing threshold and parameters measured in 12 cases of patients with cardioversion after 12 weeks postoperative cardioversion (P> 0.05); 10 cases of AF (0.8 ± 0.6) mV, which was significantly lower than that of program-controlled P wave (1.4 ± 0.5) mV (P <0.05), but there was no significant difference between the two groups (P> 0.05) . Conclusion: Atrial electrodes are safe and reliable when atrial pacemaker is inserted during the pacemaker implantation.