Schmitt C G, Ellringmann U, Köhler F
Z Kardiol. 1977 Aug;66(8):447-53.
From 1965 to 1976, implantations of 502 pacemaker electrodes were performed. In 59 patients the first lead had to be changed. In December 1976, 355 patients were under our control. At this time, 11.7 percent were no longer paced via their first lead. Dislocations of the lead, increased threshold, insulation defect, skin perforation of the lead, myocardial perforation, adaptor defects, fracture, infection, and loops of the electrode were the reasons. In cases of exit block alone, you should try to take a high output pacemaker. In cases of entrance block, a pacemaker with increased input-impedance will do its work. If those two kinds of treatment will fail, you may speak about a lead out of function. Considering extraction of the electrode, except in cases of infection, you should exercise restraint, for severe complications may result. An electrode out of function has to be protected against disappearing in a safe way. A synopsis of electrode complications including cause, therapy, and prevention is given.
1965年至1976年期间，共植入了502个起搏器电极。59名患者的第一根导线需要更换。1976年12月，355名患者处于我们的随访中。此时，11.7%的患者不再通过其第一根导线起搏。导线脱位、阈值升高、绝缘缺陷、导线皮肤穿孔、心肌穿孔、转接器缺陷、断裂、感染以及电极成环是其原因。仅在发生出口阻滞的情况下，应尝试使用高输出起搏器。在入口阻滞的情况下，具有增加输入阻抗的起搏器将起作用。如果这两种治疗方法均失败，则可能意味着导线失去功能。考虑到电极拔除，除感染情况外，应谨慎行事，因为可能会导致严重并发症。必须以安全的方式防止失功电极消失。本文给出了电极并发症的概述，包括原因、治疗和预防。
