Moss A J, Rivers R J
Circulation. 1978 Jan;57(1):103-6. doi: 10.1161/01.cir.57.1.103.
During the past ten years, pervenous atrial pacemakers have been implanted in 50 patients (mean age 68 years, 60% males) using an electrode positioned in the coronary vein. The indications for atrial pacing were symptomatic sinus bradycardia (72%), atrial brady-tachy syndrome (20%), and recurrent tachyarrhythmias (8%). Atrial pacemakers have been implanted for a total of 1531 pacing months, average 31 months per patient, median 26 months and range 3-97 months. Effective atrial pacing has been achieved with Medtronic model 5818 and 6904 electrodes. Unipolar or bipolar atrial pacing has been equally effective, and commercially available Medtronic 5950, Cordis 162 and CPI 602 pulse generators have been utilized without difficulty. A total of 11 electrode related malpacing events occurred in the ten-year period with a malpacing event rate of 10% in the first pacing month, 1.1% per paced month during the next six months, and 0.25% per paced month thereafter. Life table analysis reveals that effective atrial pacing was achieved in 76% of the patients during a follow-up of more than five years. This experience substantiates the long-term safety and effectiveness of atrial pacing from the coronary vein using standard pacemaker electrodes and generators.
在过去十年中，已使用置于冠状静脉的电极，为50例患者（平均年龄68岁，60%为男性）植入了经静脉心房起搏器。心房起搏的适应证为症状性窦性心动过缓（72%）、心房慢快综合征（20%）和复发性快速性心律失常（8%）。共植入心房起搏器1531个起搏月，平均每位患者31个月，中位数26个月，范围为3至97个月。使用美敦力5818型和6904型电极实现了有效的心房起搏。单极或双极心房起搏同样有效，且已顺利使用了市售的美敦力5950型、科迪斯162型和CPI 602型脉冲发生器。在这十年期间共发生了11次与电极相关的起搏异常事件，起搏异常事件发生率在第一个起搏月为10%，在接下来的六个月中为每个起搏月1.1%，此后为每个起搏月0.25%。寿命表分析显示，在超过五年的随访期间，76%的患者实现了有效的心房起搏。这一经验证实了使用标准起搏器电极和发生器从冠状静脉进行心房起搏的长期安全性和有效性。
