Gillette P C, Wampler D G, Shannon C, Ott D
Pacing Clin Electrophysiol. 1985 Jan;8(1):94-100. doi: 10.1111/j.1540-8159.1985.tb05728.x.
Forty pediatric and young adult patients (1-20 years; mean, 11 years of age) had implantation of atrial demand (AAI) pacemakers over a 5.5 year period. Nineteen were implanted by epicardial technique and 21 transvenously. Standard lithium single chamber pulse generators and standard atrial leads were used. Operative stimulation thresholds were better for transvenous leads than for epicardial (0.75 volts vs. 1.5 volts at 0.5 ms) (p less than 0.05). Pulse width thresholds at a mean of 1.5 years were not significantly different (0.11 ms for transvenous vs. 0.18 for epicardial). No patient developed AV block. Eight patients (four epicardial and four endocardial) required reoperation during the mean 3.5 year follow-up--four because of lead problems and four because of persistent tachycardia. Of the six patients who received an automatic antitachycardia pacemaker, only one had persistent symptoms while seven of eight who received a standard unit continued to have symptoms. Twenty-eight of 29 symptomatic patients without tachycardia became asymptomatic. Atrial pacing appears to be a safe and effective therapy for children with sick sinus syndrome.
40例儿科和年轻成人患者（年龄1 - 20岁，平均11岁）在5.5年期间植入了按需型心房（AAI）起搏器。19例采用心外膜技术植入，21例经静脉植入。使用标准锂单腔脉冲发生器和标准心房电极导线。经静脉电极导线的手术刺激阈值优于心外膜电极导线（0.5毫秒时为0.75伏对比1.5伏）（p小于0.05）。平均1.5年时的脉宽阈值无显著差异（经静脉为0.11毫秒，心外膜为0.18毫秒）。无患者发生房室传导阻滞。在平均3.5年的随访期间，8例患者（4例心外膜和4例心内膜）需要再次手术——4例因电极导线问题，4例因持续性心动过速。在接受自动抗心动过速起搏器的6例患者中，只有1例有持续症状，而接受标准起搏器的8例患者中有7例仍有症状。29例无心动过速的有症状患者中，28例无症状。心房起搏似乎是治疗儿童病态窦房结综合征的一种安全有效的方法。
