Stewart S, Cohen J, Murphy G
Chest. 1975 May;67(5):564-7. doi: 10.1378/chest.67.5.564.
The first pacemaker systems used the epicardial electrode. The transvenous endocardial electrode rapidly supplanted the epicardial electrode since it could be positioned with less morbidity and mortality and was associated with a lower incidence of wire breakage. The long term complication rate of the transvenous electrode had not been inconsequential. The sutureless epicardial electrode combines the greater reliability of the epicardial lead system with the ease of insertion and low morbidity of the endocardial lead system. We have used this electrode in 33 patients. The electrode was positioned using the subxiphoid approach and local anesthesia in most patients. There have been few complications and none that resulted in long term morbidity. There have been no deaths related either to the operative approach or to the pacing system. There has been no instance of lead failure during the follow-up period.
第一代起搏器系统采用心外膜电极。经静脉心内膜电极很快取代了心外膜电极，因为它的植入方式导致的发病率和死亡率更低，且导线断裂的发生率也较低。经静脉电极的长期并发症发生率也不容小觑。无缝合心外膜电极结合了心外膜导联系统更高的可靠性以及心内膜导联系统易于插入和低发病率的特点。我们已将这种电极应用于33例患者。大多数患者通过剑突下入路和局部麻醉来放置电极。并发症很少，且没有导致长期发病的情况。没有与手术入路或起搏系统相关的死亡病例。在随访期间没有发生导线故障的情况。
