Rodrigo Trallero G, Suárez Alzamora J, Valle Montañés J V, Yuste Serrano I, Sánchez Val A, Pacheco Arancibia G, Calderero Abad J L, Ferreira Montero I
Servicios de Cardiología, Hospital Clínico Universitario, Zaragoza.
Rev Esp Cardiol. 1990;43 Suppl 2:40-7.
To add data on controversy between the advantages and inconveniences of using either unipolar or bipolar modes for permanent cardiac pacing, we have studied 15 patients. In all of them a CPI Delta-925 (DDD) pulse generator was implanted. Non invasive pacing threshold values in volts were measured at 0.05, 0.08 and 0.1 ms for each chamber programmed either to unipolar or bipolar mode, at 1, 2, 3, 4, 5, 6, 7, 8, 14, 21, 30, 60, 90, 120, 180 and 365 days after the implant. Sensing thresholds were measured at the same time. For any pulse width the mean pacing thresholds in atrium and ventricle increase uniformly, reaching its maximum values between the days 8 and 14 after the implant and decreases to a stable value between 90 and 120 days after the implant, without statistically significant differences for both: unipolar and bipolar modes. Pacing thresholds (V +/- SD) for 0.05 ms in the day 365th were in atrium: unipolar 2.85 +/- 0.79, bipolar 3.35 +/- 0.92 (p = 0.56) and ventricle: unipolar 3.92 +/- 1.01, bipolar 4.36 +/- 1.35 (p = 0.58). Sensing thresholds in atrium and ventricle decreases from the 1st day after the implant with the minimum mean value the day 8th, increasing eventually. No statistically significant differences were found between sensing unipolar/bipolar mode at each chamber. Sensing thresholds (mV +/- SD) in the 365th day were in atrium: unipolar 4.40 +/- 2.07, bipolar 4.10 +/- 2.10 (p = 0.82) and ventricle: unipolar 11.20 +/- 3.63, bipolar 10.10 +/- 5.13 (p = 0.71).
for every single patient: 1) There are not statistically significant differences in the evolution of unipolar and bipolar pacing thresholds both in atrium and ventricle, regarding rate and time of increase, maximum value, rate of decrease and stable chronic values. 2) There are neither statistically significant differences regarding unipolar and bipolar sensing in atrium and ventricle respect to rate of decrease, time and value of the minimum and stable chronic values.
为补充关于使用单极或双极模式进行永久性心脏起搏的利弊争议的数据，我们研究了15例患者。所有患者均植入了CPI Delta - 925（DDD）脉冲发生器。在植入后的1、2、3、4、5、6、7、8、14、21、30、60、90、120、180和365天，对每个程控为单极或双极模式的腔室，分别在0.05、0.08和0.1毫秒时测量以伏特为单位的非侵入性起搏阈值。同时测量感知阈值。对于任何脉冲宽度，心房和心室的平均起搏阈值均均匀升高，在植入后第8天至14天达到最大值，然后在植入后90天至120天降至稳定值，单极和双极模式在这两方面均无统计学显著差异。在第365天，0.05毫秒时的起搏阈值（V±标准差），心房：单极2.85±0.79，双极3.35±0.92（p = 0.56）；心室：单极3.92±1.01，双极4.36±1.35（p = 0.58）。心房和心室的感知阈值从植入后第1天开始下降，在第8天达到最小平均值，最终升高。在每个腔室的单极/双极感知模式之间未发现统计学显著差异。在第365天，感知阈值（mV±标准差），心房：单极4.40±2.07，双极4.10±2.10（p = 0.82）；心室：单极11.20±3.63，双极10.10±5.13（p = 0.71）。
对于每一位患者：1）在心房和心室中，单极和双极起搏阈值在升高速率和时间、最大值、下降速率以及稳定的慢性值方面的演变没有统计学显著差异。2）在心房和心室中，单极和双极感知在下降速率、最小值和稳定慢性值的时间及数值方面也没有统计学显著差异。
