Lemke B, Hoeltmann B J, Selbach H, Barmeyer J
Medizinische Klinik und Poliklinik der Berufsgenossenschaftlichen Krankenanstalten Bergmannsheil Bochum.
Z Kardiol. 1987 Aug;76(8):484-91.
The implantation of an atrial pacing device represents an established mode of therapy for bradycardia in sinus node dysfunction. However, controversial views remain concerning the safety of this type of pacing. To investigate this, we retrospectively analysed data from 81 patients, all of whom received an AAI pacing device between 1972 and 1984. Complete AV-block developed in two out of 81 patients (cumulative incidence after 10 years was 5 +/- 3%). Atrial fibrillation developed in three out of 81 patients (cumulative incidence after 10 years was 10 +/- 5%). Lead-related complications were strongly related to the type of lead tip and the mode of fixation. The overall incidence of lead-related problems was 20 +/- 5% after 5 years and 38 +/- 12% after 10 years. 82 +/- 6% of patients survived the first 5 years, 52 +/- 14% survived for 10 years. The 5 years' survival rate was not different from that of the normal population. From this we conclude that atrial pacing can be safely done with an AAI system as long as there are no signs of an AV-block. Atrial fibrillation develops less often on AAI pacing than on VVI pacing. The risk of developing an AV-block seems rather low.
植入心房起搏装置是治疗窦房结功能障碍所致心动过缓的一种既定治疗方式。然而，对于这种起搏方式的安全性仍存在争议性观点。为对此进行研究，我们回顾性分析了81例患者的数据，所有这些患者均在1972年至1984年间接受了AAI起搏装置。81例患者中有2例发生了完全性房室传导阻滞（10年后的累积发生率为5±3%）。81例患者中有3例发生了心房颤动（10年后的累积发生率为10±5%）。导线相关并发症与导线尖端类型和固定方式密切相关。5年后导线相关问题的总体发生率为20±5%，10年后为38±12%。82±6%的患者存活了前5年，52±14%的患者存活了10年。5年生存率与正常人群无差异。由此我们得出结论，只要没有房室传导阻滞的迹象，使用AAI系统进行心房起搏是安全的。AAI起搏时心房颤动的发生率低于VVI起搏。发生房室传导阻滞的风险似乎相当低。
