Sloman J G, Mond H G, Bailey B, Cole A, Duffield A
Pacing Clin Electrophysiol. 1979 Nov;2(6):579-85. doi: 10.1111/j.1540-8159.1979.tb04276.x.
A new balloon-tipped ventricular endocardial electrode for permanent artificial cardiac pacing is described. Following transvenous insertion of the electrode to the right ventricular apex, the distal balloon is inflated with contrast material in order to wedge the electrode tip between or beneath trabeculae and prevent displacement. fifty-nine electrodes were implanted, including a second generation type incorporating a wedge tip as well as the balloon. The incidence of displacement was 17% with 10% of cases being early, and 7% late. Early in the series, 50% Urografin was used to inflate the balloon and this resulted in premature deflation and early electrode displacement in two of the nine patients. When the concentration of Urografin was reduced, the balloon remained inflated for a longer period and the incidence of early displacement was reduced to 8%. However, there was still a late displacement of 8%. Only one wedge-tipped balloon electrode displaced. This electrode had a faulty sealing mechanism and the balloon could not be adequately inflated. There was a 3% incidence of early and a 3% incidence of late threshold problems with the electrode. However, name of the wedge-tipped balloon electrodes exhibited this problem. It was concluded that this new electrode did not fulfill its objectives. The total electrode failure rate, including displacements and episodes of high threshold was approximately 24%.
本文描述了一种用于永久性人工心脏起搏的新型球囊尖端心室心内膜电极。将电极经静脉插入右心室尖部后，向远端球囊注入造影剂使其膨胀，以便将电极尖端楔入小梁之间或其下方，防止电极移位。共植入了59根电极，包括一种第二代电极，其兼具楔形尖端和球囊。电极移位发生率为17%，其中10%为早期移位，7%为晚期移位。在该系列研究早期，使用50%的泛影葡胺充盈球囊，这导致9例患者中有2例球囊过早瘪缩及电极早期移位。当降低泛影葡胺浓度时，球囊保持膨胀的时间更长，早期移位发生率降至8%。然而，仍有8%的晚期移位。仅有一根楔形尖端球囊电极发生移位。该电极的密封机制存在故障，球囊无法充分膨胀。该电极早期阈值问题发生率为3%，晚期阈值问题发生率为3%。然而，楔形尖端球囊电极中只有一种出现了此问题。得出的结论是，这种新型电极未达到其预期目标。包括移位和高阈值发作在内的电极总故障率约为24%。
