Beyersdorf F, Kreuzer J, Schmidts L, Satter P
Pacing Clin Electrophysiol. 1985 Jul;8(4):562-8. doi: 10.1111/j.1540-8159.1985.tb05860.x.
Since 1978, 2,365 polyurethane (PU) insulated cardiac pacing leads were implanted transvenously at our institution. To date, there have been no insulation failures in those leads. Thirty-seven PU leads were explanted, mainly for exit block, and 28 of these were investigated using the scanning electron microscope. We found a homogeneous distribution of surface changes in all lead segments in 56% of the 28 examined. These changes were more pronounced at the ligature site; severe surface cracking was noticed in 21%, with the deepest crack being 40 micron (average range of 10-15 micron). There appeared to be no time-dependency of the surface changes as indicated by regression analysis (r = 0.32, p greater than 0.05). The ultimate severity and outcome of this degradation process in the leads reported in this study will only be known in the future after longer use. We conclude that excess stress must be avoided during the implantation procedure and that careful surveillance is necessary.
自1978年以来，我们机构经静脉植入了2365根聚氨酯（PU）绝缘心脏起搏导线。迄今为止，这些导线未发生绝缘故障。37根PU导线被取出，主要原因是出口阻滞，其中28根使用扫描电子显微镜进行了检查。我们发现，在28根被检查导线中，56%的导线所有节段表面变化分布均匀。这些变化在结扎部位更为明显；21%的导线出现严重表面裂纹，最深裂纹为40微米（平均范围为10 - 15微米）。回归分析表明，表面变化似乎不存在时间依赖性（r = 0.32，p大于0.05）。本研究中报告的导线这种降解过程的最终严重程度和结果，只有在长期使用后才能知晓。我们得出结论，在植入过程中必须避免过度应力，并且有必要进行仔细监测。
