Mantle J A, Massing G K, James T N, Russell R O, Rackley C E
Chest. 1977 Sep;72(3):285-90. doi: 10.1378/chest.72.3.285.
A new multipurpose flow-directed pulmonary arterial catheter has been developed and evaluated in 30 patients with acute cardiopulmonary dysfunction. The catheter permits monitoring of the bipolar atrial electrogram, pulmonary arterial or wedge pressure, central venous pressure, and cardiac output, plus atrial pacing. The standard Swan-Ganz thermistor-equipped catheter was modified to incorporate two ring electrodes on the shaft at 25 and 26 cm from the tip. With the pair of electrodes positioned in the right atrium at the junction with the superior vena cava, stable electrograms of high quality were recorded in all 30 subjects, some for as long as six days. These high-fidelity atrial electrograms permitted rapid and accurate diagnosis of many complex dysrhythmias in these unstable patients. Because of the limited noise in the signal of the electrogram, continuous quantitative measurements of intervals by a computerized system was feasible. Furthermore, the stable intracavitary position of electrodes provided a reliable site for atrial pacing, with pacing thresholds (2 to 12 ma; average, 5 ma) that remained stable for up to four days. Atrial pacing was used to treat sinus bradycardia, atrial tachyarrhythmias, digitalis intoxication, and ventricular dysrhythmias.
一种新型多功能血流导向肺动脉导管已被研发出来，并在30例急性心肺功能不全患者中进行了评估。该导管可用于监测双极心房电图、肺动脉压或楔压、中心静脉压和心输出量，还具备心房起搏功能。对标准的配备热敏电阻的Swan-Ganz导管进行了改良，在距尖端25和26厘米处的导管轴上增加了两个环形电极。当这对电极置于上腔静脉与右心房交界处的右心房内时，所有30名受试者均记录到了高质量的稳定心电图，部分记录长达6天。这些高保真心房电图有助于对这些不稳定患者的许多复杂心律失常进行快速准确的诊断。由于心电图信号中的噪声有限，利用计算机系统对间期进行连续定量测量是可行的。此外，电极在腔内的稳定位置为心房起搏提供了可靠位点，起搏阈值（2至12毫安；平均5毫安）可稳定长达4天。心房起搏被用于治疗窦性心动过缓、房性快速心律失常、洋地黄中毒和室性心律失常。
