Markewitz A, Kronski D, Kammeyer A, Kaulbach H, Weinhold C, Doering W, Reichart B
Department of Cardiac Surgery, University of Munich, Grosshadern Hospital, Germany.
Pacing Clin Electrophysiol. 1995 Dec;18(12 Pt 1):2116-20. doi: 10.1111/j.1540-8159.1995.tb04635.x.
The aim of this study was to investigate the effect of battery capacity, internal current drain, and stimulation energy on pulse generators longevity, and if battery impedance measurements can reliably predict pulse generators end-of-life. For this purpose, the records of 577 patients with a mean age of 65 +/- 14 years who had undergone implantation of two different dual chamber pulse generators (PG1: 409; PG2: 168) were retrospectively reviewed. Battery capacity were 2.3 Ah (PG1) and 3.0 Ah (PG2) while current drain at comparable nominal settings was 20 microA (PG1) and 30 microA (PG2) indicating a higher internal current drain of PG2. After a mean follow-up of 46 +/- 23 months, stimulation energy at reprogrammed output settings was significantly higher in PG1 as compared to PG2 (17.1 +/- 0.14) vs 15.5 +/- 0.24 J). Three PG1 (0.7%) and 12 PG2 (7.1%) (P < 0.01) had to be exchanged after a mean of 77.3 +/- 5.3 months (PG1) and 75 +/- 13.5 months (PG2) (P = NS) due to end-of-life being reached. The difference in battery impedances of PG1 and PG2 gained statistical significance 5 years after implantation (1.0 k omega vs 2.4 +/- 6.7 k omega) preceding the significant difference in PG survival after 6 years (98.7 +/- 1.3% vs 90.7 +/- 4.8%). These results indicate that internal current drain is the most important determinant of the pulse generators longevity and that battery impedance can reliably predict end-of-life. Therefore, the essential information about internal current drain should be available for each pacemaker, since it is required for adequate pulse generator selection. Diagnostic functions of dual chamber pulse generators should include measurements of battery impedance.
本研究的目的是调查电池容量、内部电流消耗和刺激能量对脉冲发生器寿命的影响，以及电池阻抗测量是否能够可靠地预测脉冲发生器的使用寿命结束。为此，回顾性分析了577例平均年龄为65±14岁的患者的记录，这些患者植入了两种不同的双腔脉冲发生器（PG1：409例；PG2：168例）。PG1的电池容量为2.3 Ah，PG2为3.0 Ah，而在可比的标称设置下，PG1的电流消耗为20 μA，PG2为30 μA，这表明PG2的内部电流消耗更高。平均随访46±23个月后，PG1重新编程输出设置下的刺激能量显著高于PG2（17.1±0.14 J对15.5±0.24 J）。平均77.3±5.3个月（PG1）和75±13.5个月（PG2）（P=无显著性差异）后，由于达到使用寿命结束，3例PG1（0.7%）和12例PG2（7.1%）（P<0.01）不得不进行更换。PG1和PG2的电池阻抗差异在植入后5年具有统计学意义（1.0 kΩ对2.4±6.7 kΩ），早于6年后PG存活率的显著差异（98.7±1.3%对90.7±4.8%）。这些结果表明，内部电流消耗是脉冲发生器寿命的最重要决定因素，电池阻抗可以可靠地预测使用寿命结束。因此，每个起搏器都应提供有关内部电流消耗的基本信息，因为这是选择合适脉冲发生器所必需的。双腔脉冲发生器的诊断功能应包括电池阻抗测量。
