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[圣卡米洛医院(罗马)心内科心脏起搏治疗经验(作者译)]

[The experience in cardiac pacing at the Cardiology Department of St. Camillo Hospital (Rome) (author's transl)].

作者信息

Di Mascolo R, Rocchi M, Alliegro A, Dini P, Messina G, Santini M

出版信息

G Ital Cardiol. 1978;8 Suppl 1:145-53.

PMID:754943
Abstract

The experience of the Cardiac Electrostimulation Center of S. Camillo Hospital in Rome on 1503 patients treated with permanent pacemakers for an 11 year period is referred. The Authors analyze the increase of the activity of the Center during these years and some events that caused it. 94.5% of the patients were more than 50 years old; the dominant pathology has been ischemic and idiopathic cardiopathy, which together include 94.7% of the totality. The indication to the implant has been A-V block in 70% of the patients; intraventricular block in 20%; sick sinus syndrome in 10%. In the last years the prophylactic indication has increased (from 0.4% to 4.4%). 2459 pacemakers have been used, of which 79.5% was QRS-inhibit. The mercury prosthesis have been progressively substituted with the lithium ones. 1642 catheters (implant and reimplant) have been used; principally endocardic (95%) and monopolar (85%). The substitution of the catheter has been necessary in 9% of the totality; in 2.6% of the endocardic and in 15.9% of the epimyocardic. Among 50 electrodes, after a period of observation of about 7.7 years, 36 are still in function. The percentage of the complications has been 17.1%; the most important complications have been: dislocation (6%), microdislocation (1.5%), late high threshold (2.1%), failure of catheter (1.2%), generator malfunction (2.3%). The total mortality has been 15.4%; 0.2% caused by deficit of the implant; 2% sudden deaths and 13.2% not depending from the implant; 243 patients (16%) are not to be found. The frequency of out-patients controls has decreased in the last 2 years (from 3.8 controls per years to 1.8).

摘要

本文提及罗马圣卡米洛医院心脏电刺激中心在11年期间对1503例接受永久性起搏器治疗患者的经验。作者分析了这些年该中心业务量的增长情况以及导致增长的一些事件。94.5%的患者年龄超过50岁;主要病理情况为缺血性和特发性心脏病,两者合计占总数的94.7%。植入起搏器的指征为:70%的患者为房室传导阻滞;20%为室内传导阻滞;10%为病态窦房结综合征。在过去几年中,预防性植入指征有所增加(从0.4%增至4.4%)。共使用了2459台起搏器,其中79.5%为QRS抑制型。汞电池起搏器已逐渐被锂电池起搏器所取代。共使用了1642根导管(植入和再次植入);主要为心内膜导管(95%)和单极导管(85%)。总计9%的导管需要更换;心内膜导管更换率为2.6%,心外膜导管更换率为15.9%。在50根电极中,经过约7.7年的观察期后,36根仍在正常工作。并发症发生率为17.1%;最重要的并发症有:电极脱位(6%)、微脱位(1.5%)、晚期高阈值(2.1%)、导管故障(1.2%)、发生器故障(2.3%)。总死亡率为15.4%;0.2%由植入操作失误导致;2%为猝死;13.2%与植入无关;243例患者(16%)失访。过去两年门诊复查频率有所下降(从每年3.8次降至1.8次)。

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