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目的:阐述起搏器噪音反转功能的设计思想、启动因素、心电图表现及处理方法。方法:对5例植入心脏起搏器后发生噪音反转患者病例资料进行分析。结果:4例因发生快速心律失常而启动起搏器噪音反转功能,程控缩短起搏器心室后不应期可使其终止。1例因肌电位干扰而启动起搏器噪音反转功能,程控降低感知灵敏度并将感知极性改为双极可终止噪音反转。结论:噪音反转是现代起搏器的一种重要的保护性功能,其启动有心脏自身和心脏外2种因素,心电图表现与感知不良容易混淆,应认真鉴别并正确处理。
Objective: To describe the design idea, starting factor, electrocardiogram performance and treatment of pacemaker noise inversion function. Methods: The data of 5 patients with noise inversion after implantation of cardiac pacemaker were analyzed. Results: In 4 cases, pacemaker noise inversion was initiated due to tachyarrhythmia, and programmed shortening of pacemaker ventricular refractory period could be terminated. One case started pacemaker noise inversion due to myoelectric potential disturbances, programmed to reduce the perceived sensitivity and change the perceived polarity to bipolar to terminate the noise reversal. CONCLUSION: Noise inversion is an important protective function of modern pacemaker. It starts with two kinds of factors, heart itself and heart. Electrocardiogram manifestation and perception are easily confused and should be carefully identified and correctly treated.