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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Effect of lead design and pacing vector on electrical parameters of quadripolar coronary sinus leads: The RALLY‐X4 study
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Effect of lead design and pacing vector on electrical parameters of quadripolar coronary sinus leads: The RALLY‐X4 study

机译：铅设计和起搏载体对Quadripolar冠状窦引线电参数的影响：Rally-X4研究

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Abstract Background Various lead designs have been developed to accommodate different coronary sinus anatomies. Our objectives were to compare electrical parameters of straight and spiral left ventricular leads, to evaluate capture thresholds and impedances using different pacing vectors, and to study evolution of thresholds over time. Methods The RALLY‐X4 study enrolled patients implanted with a lead from the Acuity X4 family (straight, spiral short, or spiral long). Electrical parameters (including capture thresholds from all 17 vectors) were measured at baseline and follow‐up. Results Data from 795 patients who were successfully implanted were analyzed. Straight and spiral leads had similar proportions of patients with thresholds 2.5?V/0.4?ms using the distal electrode (61‐65% of patients) or from at least one of the proximal (E2‐E4) electrodes (81‐83% of patients). Unipolar vectors had significantly lower thresholds and impedances than bipolar vectors, with similar measurements compared to extended bipolar configurations. Capture thresholds increased with more proximal electrodes for all leads. Over a mean follow‐up of 1?year, a slight decrease in capture thresholds was observed. Conclusion Straight and spiral quadripolar leads allow to obtain clinically acceptable capture thresholds from at least one of the proximal electrodes in 80% of patients. Pacing vectors significantly affect electrical parameters, with higher thresholds in more proximal electrodes and lower thresholds with unipolar and extended bipolar configurations. Capture thresholds slightly decreased over a mean follow‐up of 1?year.
机译：抽象背景已经开发出各种引导设计来适应不同的冠状动脉窦解剖。我们的目标是比较直率和螺旋左心室引线的电参数，评估使用不同起搏载体的捕获阈值和阻抗，并随着时间的推移研究阈值的演变。方法RATAL-X4研究注册患者植入敏锐X4家族的铅（直，螺旋短，长长）。在基线和随访中测量电气参数（包括所有17个载体的捕获阈值）。结果分析了795名成功植入的患者的数据进行了分析。直线和螺旋引线具有类似的阈值患者的比例，阈值≤2.5？V / 0.4？MS使用远端电极（61-65％的患者）或近端（E2-E4）电极中的至少一个（81-83 ％患者）。与双极载体的阈值和阻抗具有显着较低的阈值和阻抗，与扩展双极配置相比具有相似的测量。捕获阈值随着所有引线的更多近端电极而增加。在1年的平均随访中，观察到捕获阈值的略微降低。结论直线和螺旋四极管导线允许从＆gt中的至少一个近似电极中获得临床上可接受的捕获阈值。80％的患者。起搏载体显着影响电参数，在更多近端电极中具有更高的阈值，并且具有单极和扩展双极配置的较低阈值。捕获阈值略有下降1？一年的平均随访。

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