Pistolese M, Boccadamo R, Altamura G
G Ital Cardiol. 1978;8 Suppl 1:71-80.
The criteria commonly followed for the choice of a cardiac pacemaker to be used in the treatment of AV blocks and sick sinus syndrome are described. In case of AV block, the AA, believe that at first implant a ventricular inhibited pacemaker is to be preferred, while for the replacements the choice will be based on clinical grounds (mainly from the data obtained during the periodic controls, such as persistence of spontaneous activity, failure of sensing, etc.). In case of sick sinus syndrome, ventricular inhibited pacemakers are generally to be preferred firstly to secure stimulation even in case of AV block, secondly for the advantage of a greater stability of the endoventricular catheter. Atrial pacemakers (asynchronous, on demand, or bifocal) will be preferred when the atrial contribution is believed to be important from an haemodynamic point of view. Lastly, in single cases, its is possible to implant radiofrequency devices connected with the electrocatheter for the control of the tachyarrhythmic phases.
本文描述了在治疗房室传导阻滞和病态窦房结综合征时选择心脏起搏器通常遵循的标准。对于房室传导阻滞,AA认为,起初植入心室抑制型起搏器更为可取,而对于更换起搏器,选择将基于临床依据(主要来自定期检查期间获得的数据,如自发活动的持续存在、感知失败等)。对于病态窦房结综合征,通常首先优选心室抑制型起搏器,一是为了即使在房室传导阻滞的情况下也能确保刺激,二是因为心室内导管具有更高的稳定性。当从血流动力学角度认为心房的作用很重要时,将优先选择心房起搏器(非同步、按需或双焦点)。最后,在个别情况下,可以植入与电导管相连的射频装置来控制快速心律失常阶段。