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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Two-coil versus single-coil transvenous cardioverter defibrillator systems: comparative data.
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Two-coil versus single-coil transvenous cardioverter defibrillator systems: comparative data.

机译：两线圈与单线圈静脉心脏复律除颤器系统：比较数据。

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Two types of new-generation transvenous implantable cardioverter defibrillator (ICD) systems, incorporating a two-coil (62 patients, group 1) versus single-coil (32 patients, group 2) lead system were compared among 94 consecutive patients. The two groups were comparable in age (58 +/- 13 vs 59 +/- 14 years), presenting arrhythmia (ventricular tachycardia versus ventricular fibrillation 77%/21% vs 84%/13%), cycle length of induced VT (294 +/- 4 vs 289 +/- 44 ms), number of unsuccessful antiarrhythmic drugs (1.7 +/- 0.8 vs 1.7 +/- 0.7), and left ventricular ejection fraction (35 +/- 12% vs 34 +/- 9%). Both systems were successfully implanted strictly transvenously in all patients. Biphasic shocks were used in all patients. Active shell devices were used in 79% and 84% patients of groups I and II, respectively (P = NS). Intraoperative testing revealed comparable defibrillation threshold (DFT) values (10.2 +/- 3.7 J in group 1 versus 9.3 +/- 3.6 J in group 2 system), and pacing threshold (0.7 +/- 0.3 vs 0.7 +/- 0.3 V), but R wave amplitude and lead impedance were lower in group 1 (13 +/- 5 vs 16 +/- 5 mV, P = 0.003; and 579 +/- 115 vs 657 +/- 111 ohms, P = 0.002, respectively). Lead insulation break requiring reoperation occurred in one patient with an Endotak lead, and two patients with Transvene leads had initially high DFT with a single one-lead/active can system, which was converted to a two- or three-endocardial-lead/inactive can configuration. We conclude that both single-coil and two-coil transvenous ICD systems were associated with high rates of successful strictly transvenous ICD implantation and a low incidence of lead-related complications. Significant differences were noted in the sensed R wave and lead impedance, probably reflecting the active fixation characteristics of the Transvene lead. However, in order to obviate the sporadic need for implantation of additional endocardial leads, as was the case in two patients in this series, a double-coil lead may be preferable.
机译：在94例连续患者中比较了两种类型的新一代静脉植入式心脏复律除颤器（ICD）系统，分别采用两线圈（62例患者，第1组）和单线圈（32例患者，第2组）引线系统。两组的年龄相当（58 +/- 13 vs 59 +/- 14岁），表现为心律失常（室性心动过速与心室纤颤77％/ 21％vs 84％/ 13％），诱发性VT的周期长度（294 +/- 4 vs 289 +/- 44 ms），抗心律失常药物失败的数量（1.7 +/- 0.8 vs 1.7 +/- 0.7）和左心室射血分数（35 +/- 12％vs 34 +/- 9 ％）。两种系统均成功地严格经静脉植入所有患者。所有患者均使用双相电击。主动外壳装置分别用于I组和II组的79％和84％的患者（P = NS）。术中测试显示除颤阈值（DFT）值相当（第1组为10.2 +/- 3.7 J，第2组系统为9.3 +/- 3.6 J）和起搏阈值（0.7 +/- 0.3 vs 0.7 +/- 0.3 V） ，但第1组的R波幅值和导线阻抗较低（13 +/- 5 vs 16 +/- 5 mV，P = 0.003; 579 +/- 115 vs 657 +/- 111 ohms，P = 0.002 ）。一名Endotak铅患者发生了需要重新手术的导线绝缘断裂，而两名具有Transvene铅的患者最初具有高的DFT，并且只有一个单铅/活动罐系统，然后转换为两或三心内膜铅/无效可以配置。我们得出的结论是，单线圈和两线圈静脉ICD系统均与成功的严格静脉ICD植入成功率高和铅相关并发症的发生率低相关。在感测到的R波和导线阻抗中发现了显着差异，可能反映了Transvene导线的主动固定特性。但是，为了避免零星地植入其他心内膜导线的需要，就像本系列中两名患者的情况一样，双线圈导线可能是更好的选择。

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