Ansani L, Percoco G F, Guardigli G, Toselli T, Antonioli G E
Divisione di Cardiologia, Arcispedale S. Anna, Ferrara, Italy.
Pacing Clin Electrophysiol. 1994 Nov;17(11 Pt 2):1865-9. doi: 10.1111/j.1540-8159.1994.tb03764.x.
To assess the long-term capability of single atrioventricular (AV) lead VDD pacing systems using close atrial dipoles to assure reliable atrial guided pacing, the safety and efficacy of 86 VDD units implanted in 73 patients at a single center since November 1988 was reviewed. All patients suffered from advanced AV block with normal sinoatrial function. Sixty five patients received a LEM/CCS Twinal 30/30S system, four patients received a Vitatron-Saphir system, and four patients received a Medtronic Thera VDR 8348 system. All patients underwent provocative tests in search of myopotential interference, and Holter recordings; in a group of patients who underwent pacemaker replacement a comparison was made between implant and replacement measurements. The mean follow-up duration was 27.3 months. A high percentage of successfully VDD paced patients and a low incidence of pacemaker malfunction, regularly solved by pacemaker reprogramming, was reported. Atrial signal amplitudes comparable to those measured at implant were found at replacement in all patients. These data support the long-term reliability of single AV lead VDD pacing systems with closely spaced atrial dipoles, as well as stable atrial sensing by floating bipolar atrial electrodes and effective atrial synchronous ventricular pacing over time.
为评估使用紧密心房偶极的单房室（AV）导联VDD起搏系统确保可靠心房引导起搏的长期能力，回顾了自1988年11月以来在单一中心植入73例患者体内的86个VDD装置的安全性和有效性。所有患者均患有伴有正常窦房结功能的高度房室传导阻滞。65例患者接受了LEM/CCS Twinal 30/30S系统，4例患者接受了Vitatron-Saphir系统，4例患者接受了美敦力Thera VDR 8348系统。所有患者均接受了寻找肌电位干扰的激发试验和动态心电图记录；在一组接受起搏器更换的患者中，对植入和更换测量结果进行了比较。平均随访时间为27.3个月。报告显示，成功进行VDD起搏的患者比例很高，起搏器故障发生率很低，通过起搏器重新编程可定期解决。在所有患者更换起搏器时，发现心房信号幅度与植入时测量的幅度相当。这些数据支持了具有紧密间隔心房偶极的单AV导联VDD起搏系统的长期可靠性，以及浮动双极心房电极对心房的稳定感知和随时间推移有效的心房同步心室起搏。
