Rosenqvist M, Nordlander R, Andersson M, Edhag O
Pacing Clin Electrophysiol. 1986 May;9(3):417-21. doi: 10.1111/j.1540-8159.1986.tb04497.x.
Myopotential inhibition during permanent pacing with unipolar leads is a well-recognized clinical problem. A study was undertaken to determine if implantation of the generator in abdominal subcutaneous tissue instead of the conventional pectoral implantation site would reduce the incidence of this inhibition. Forty patients with either an abdominal (group A, n = 20) or a pectoral (group P, n = 20) generator implantation site were subjected to a standardized protocol of muscle provocation and 24-hour ECG. Pulse generators were programmed to the lowest sensitivity level (average, 2.0 mV). Pauses exceeding the stimulation interval were analyzed. During muscle provocation 85% of the patients in group P displayed inhibition, as against 5% in group A (p less than 0.001). During 24-hour ECG, the corresponding values were 95% and 15%, respectively (p less than 0.001). We concluded that abdominal generator implantation significantly reduces the incidence of myopotential inhibition in patients with unipolar pacemaker leads.
使用单极导线进行永久起搏时的肌电位抑制是一个公认的临床问题。本研究旨在确定将起搏器植入腹部皮下组织而非传统的胸部植入部位是否会降低这种抑制的发生率。40例患者被分为两组，其中20例患者的起搏器植入腹部（A组），另外20例患者的起搏器植入胸部（P组），所有患者均接受标准化的肌肉激发试验和24小时心电图监测。将脉冲发生器程控到最低灵敏度水平（平均2.0 mV），分析超过刺激间期的长间歇。在肌肉激发试验期间，P组85%的患者出现抑制，而A组为5%（p<0.001）。在24小时心电图监测期间，相应的值分别为95%和15%（p<0.001）。我们得出结论，对于使用单极起搏器导线的患者，将起搏器植入腹部可显著降低肌电位抑制的发生率。
