Sethi K K, Bhargava M, Mohan J C, Pandit N, Khan J A, Gokhale C S, Kaul U A, Arora R, Khalilullah M
Department of Cardiology, G B Pant Hospital, New Delhi.
Indian Heart J. 1994 Mar-Apr;46(2):71-5.
Long term performance of 163 atrial leads implanted in 158 patients between July 1981 and June 1993 was evaluated. There were 122 DDD and 36 AAI units, with 125 (77%) polyurethane and 38 (23%) silicone leads. One hundred and nine (67%) unipolar and 54 (33%) bipolar leads were used. Patients were followed in the Pacemaker Clinic for 6 to 124 months (mean 50 +/- 39 months). Five patients were lost to follow up. Transient malfunction was observed in 18 cases (sensing 13, pacing 5) within the first 2 weeks. In 13 cases failure to sense subsided spontaneously and in 4 pacing malfunction could be corrected by reprogramming. Lead dislodgement occurred in 4 patients (2.5%), all within the first week. After the 1st month malfunction was uncommon. Between 1 and 12 months undersensing occurred in 4 (2.5%). In 3 cases it could be corrected by reprogramming. In the first year, reoperation was performed in 5 cases for lead related problems (3 dislodgements, 2 insulation failures). Beyond 12 months complications were as follows: failure to sense-8 (5%), failure to pace-3 (2%), insulation break -1 (0.6%). Majority of these problems could be managed by reprogramming. Reoperation was performed in 1 case with insulation break. The pacing mode had to be changed in 5 (3%) patients with dual chamber units who had loss of P wave sensing. During follow-up 98%, 98%, 96%, 95% and 83% of the leads were working satisfactorily at 1,2,3,4 and 9 years respectively. Thus atrial leads have excellent long term performance and an acceptable rate of late malfunction.
对1981年7月至1993年6月期间158例患者植入的163根心房导线的长期性能进行了评估。有122台DDD和36台AAI装置，其中125根（77%）为聚氨酯导线，38根（23%）为硅胶导线。使用了109根（67%）单极导线和54根（33%）双极导线。患者在起搏器门诊随访6至124个月（平均50±39个月）。5例患者失访。在最初2周内，18例（感知不良13例，起搏故障5例）出现短暂故障。13例感知不良自行缓解，4例起搏故障可通过重新编程纠正。4例患者（2.5%）发生导线脱位，均在第一周内。1个月后故障不常见。1至12个月期间，4例（2.5%）出现感知不足。3例可通过重新编程纠正。第一年，5例因导线相关问题进行了再次手术（3例脱位，2例绝缘故障）。12个月后并发症如下：感知不良8例（5%），起搏故障3例（2%），绝缘破损1例（0.6%）。这些问题大多数可通过重新编程解决。1例绝缘破损患者进行了再次手术。5例（3%）双腔装置患者出现P波感知丧失，起搏模式不得不改变。随访期间，分别有98%、98%、96%、95%和83%的导线在1年、2年、3年、4年和9年时工作良好。因此，心房导线具有出色的长期性能和可接受的晚期故障率。
