Schwartzman D, Concato J, Ren J F, Callans D J, Gottlieb C D, Preminger M W, Marchlinski F E
The Clinical Electrophysiology Laboratory of the Philadelphia Heart Institute, PA 19104, USA.
Am Heart J. 1996 Jun;131(6):1127-36. doi: 10.1016/s0002-8703(96)90087-3.
Two hundred forty-three consecutive patients underwent attempted implantation of nonthoracotomy defibrillation lead (NTL) systems. The importance of clinical and lead-related factors were analyzed regarding their relation with implantation failure caused by an unacceptably high defibrillation threshold (DFT). Overall, 33 (14%) of 243 patients failed NTL implantation. Patients undergoing attempted implantation of NTL systems with monophasic shock waveforms (monophasic group, n = 145) had an incidence of failed implantation of 22% (n = 32) versus an incidence of 1% (n = 1) among patients undergoing attempted implantation by using biphasic shock waveforms (biphasic group, n = 98; odds ratio, 26.9; p < 0.001). The incidence of success and simplicity of implantation of NTL systems was markedly improved in patients undergoing NTL implantation by using biphasic shock waveforms. Clinical factors could be used to stratify patients in the monophasic group for their risk of implantation failure. In the biphasic group, no clinical factor could be correlated with a low DFT with a fully endovascular system.
243例连续患者接受了非开胸除颤导线（NTL）系统的植入尝试。分析了临床和导线相关因素与因除颤阈值（DFT）过高导致植入失败的关系。总体而言，243例患者中有33例（14%）NTL植入失败。接受单相电击波形NTL系统植入尝试的患者（单相组，n = 145）植入失败发生率为22%（n = 32），而接受双相电击波形植入尝试的患者（双相组，n = 98）植入失败发生率为1%（n = 1）（优势比，26.9；p < 0.001）。使用双相电击波形进行NTL植入的患者，NTL系统植入的成功率和简便性显著提高。临床因素可用于对单相组患者植入失败风险进行分层。在双相组中，没有临床因素与完全血管内系统的低DFT相关。
