Glikson M, von Feldt L K, Suman V J, Hayes D L
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic, Rochester, Minnesota 55905, USA.
Pacing Clin Electrophysiol. 1996 Oct;19(10):1469-73. doi: 10.1111/j.1540-8159.1996.tb03160.x.
Since 1989, 136 Medtronic 4058 and 4058M bipolar atrial screw-in leads have been implanted at the Mayo Clinic. Early lead related complications included dislodgment in 4 (2.9%). Over a median follow-up time of 14.4 months (1 day to 3.3 years), there were 11 lead related complications (undersensing, failure to capture, diaphragmatic pacing, and gross lead dislodgment). Chronic complications resulted in reoperations in four patients (2.9%). Of 77 patients in whom pacing thresholds were measured between 2 and 4 months after implantation, 9 (11.7%) and 2 (2.6%) had high pacing thresholds and very high thresholds, respectively. The Kaplan-Meier estimate of the probability of 1-year complication-free lead survival was 93.5%. There were no lead material failures. We conclude that the 4058/4058M lead implanted in the atrial position has favorable acute and chronic performance data, with a tendency toward high pacing thresholds at 3 months. The cause of this phenomenon and its course over time should be further evaluated.
自1989年以来，梅奥诊所已植入136根美敦力4058型和4058M型双极心房螺旋电极导线。早期与导线相关的并发症包括4例（2.9%）导线脱位。在中位随访时间14.4个月（1天至3.3年）内，发生了11例与导线相关的并发症（感知不足、夺获失败、膈肌起搏和导线严重脱位）。慢性并发症导致4例患者（2.9%）再次手术。在植入后2至4个月测量起搏阈值的77例患者中，分别有9例（11.7%）和2例（2.6%）出现高起搏阈值和极高起搏阈值。1年无并发症导线存活概率的Kaplan-Meier估计值为93.5%。未发生导线材料故障。我们得出结论，植入心房位置的4058/4058M型导线具有良好的急性和慢性性能数据，但在3个月时存在起搏阈值升高的趋势。这种现象的原因及其随时间的变化过程应进一步评估。
