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首页> 外文期刊>PACE: Pacing and clinical electrophysiology >Implantation and follow-up of ICD leads implanted in the right ventricular outflow tract.
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Implantation and follow-up of ICD leads implanted in the right ventricular outflow tract.

机译：ICD导线的植入和随访，植入右心室流出道。

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摘要

Unipolar ICD electrodes are routinely implanted at the right ventricular apex (RVA). However, inappropriate pacing/sensing parameters and/or high DFT may limit the appropriateness of the lead's implantation at the RVA. This study examined the effects on DFT of ICD leads implanted in the RVOT, attached to the high interventricular septum as an alternate location. DFT, defibrillation impedance, and sensing and pacing characteristics were measured at the time of implantation in 28 consecutive patients. Group A consisted of 12 patients in whom the ICD implantation criteria in the RVA were not satisfied, and whose lead was placed in the RVOT. Group B consisted of 16 patients with ICD electrodes implanted at the RVA. Mean DFT in group A was 11 +/- 4 J (4.5-20 J) versus 12 +/- 6 J (4-20 J) in the group B (P = 0.58). Defibrillation impedance was 81 +/- 9 omega (69-92 omega) in group A versus 77 +/- 15 omega) (46-93 omega) in group B (P = 0.43). R wave amplitude, slew rate, pacing threshold, and pacing impedance were comparable in both groups. In the perioperative period, the electrode needed to be repositioned in two patients from group A. There was no further dislodgment of RVOT defibrillation leads or other lead related complications during a follow-up of 23 +/- 9 months. The placement of ICD leads in the RVOT is an alternative to the RVA position. However, active-fixation ICD leads should be considered to limit the risk of electrode dislodgment.
机译：常规将单极ICD电极植入右心尖（RVA）。但是，不合适的起搏/传感参数和/或较高的DFT可能会限制引线在RVA处植入的适当性。这项研究检查了植入RVOT的ICD引线对DFT的影响，该RVOT附着在高室间隔作为替代位置。在连续植入28例患者时，测量了DFT，除颤阻抗以及传感和起搏特性。 A组由12例患者组成，其中RVA中的ICD植入标准不满意，并且其导线放置在RVOT中。 B组由16名在RVA植入ICD电极的患者组成。 A组的平均DFT为11 +/- 4 J（4.5-20 J），而B组的平均DFT为12 +/- 6 J（4-20 J）（P = 0.58）。 A组的除颤阻抗为81 +/- 9Ω（69-92Ω），而B组为77 +/- 15Ω（46-93Ω）（P = 0.43）。两组的R波振幅，摆率，起搏阈值和起搏阻抗均相当。在围手术期，需要从A组的两名患者中重新放置电极。在23 +/- 9个月的随访期间，没有进一步清除RVOT除颤导线或其他导线相关的并发症。在RVOT中放置ICD引线是RVA位置的替代方法。但是，应考虑采用主动固定ICD引线来限制电极脱落的风险。

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