Alt E, Völker R, Blömer H
Thorac Cardiovasc Surg. 1987 Apr;35(2):101-4. doi: 10.1055/s-2007-1020206.
We studied the incidence of lead fractures in 2,226 patients with a total follow-up period of 8,558 patient years. Lead fractures occurred in 100 out of 2,563 implanted leads (3.9%). This corresponds to an average rate of 1.2% per patient year. We found 62 out of 881 singlefilar coil leads fractured (7.0%), 20 out of 809 Siemens Elema 588 leads (2.5%) and only 6 out of 630 multifilar soil leads (1.0%). Lead fractures occurred at a significantly (p less than 0.05) higher rate in singlefilar coil leads than in Simens Elema 588 leads or in multifilar coil leads. Independent of the type of lead, a significantly (p less than 0.05) higher fracture rate was found with leads implanted through the internal jugular vein. Most fractures occurred either inside the pacemaker pocket or on the way from the connector to the venous entry. Only 7% of all fractures occurred within the vascular system. Patients with a second or third degree AV-block and a multifilar coil lead implanted showed a significantly (p less than 0.05) better survival rate compared to those with a singlefilar coil or a Siemens Elema 588 lead. In pacemaker-dependent patients a replacement of singlefilar coil leads might be considered.
我们研究了2226例患者的铅质导线骨折发生率，总随访期为8558患者年。2563根植入导线中有100根发生了铅质导线骨折（3.9%）。这相当于平均每年每例患者的发生率为1.2%。我们发现881根单丝线圈导线中有62根骨折（7.0%），809根西门子Elema 588导线中有20根骨折（2.5%），而630根多丝线圈导线中只有6根骨折（1.0%）。单丝线圈导线的铅质导线骨折发生率显著高于（p<0.05）西门子Elema 588导线或多丝线圈导线。无论导线类型如何，经颈内静脉植入的导线骨折发生率显著更高（p<0.05）。大多数骨折发生在起搏器囊袋内或从连接器到静脉入口的途中。所有骨折中只有7%发生在血管系统内。与植入单丝线圈导线或西门子Elema 588导线的患者相比，植入多丝线圈导线的二度或三度房室传导阻滞患者的生存率显著更高（p<0.05）。对于起搏器依赖型患者，可考虑更换单丝线圈导线。
