Buffle P J
J Thorac Cardiovasc Surg. 1976 Aug;72(2):226-31.
One hundred eighty-seven electrode systems were implanted in 158 consecutive patients--30 systems implanted by thoracotomy, 98 transvenous, and 52 epigastric transdiaphragmatic systems--and the long-term results were compared. With electrodes placed by thoracotomy there was a high rate of complication (76 per cent), prolonging the initial hospitalization (33 per cent) and necessitating frequent rehospitalizations (56 per cent). With transvenous electrodes the complication rate was 39 per cent (16 per cent during the first hospitalization, 28 per cent necessitating rehospitalization). With epigastric transdiaphragmatic electrodes these figures were, respectively, 15, 12, and 6 per cent. The most frequent complications with transvenous electrodes were displacement (15 per cent), ulcerations, and local infection; all were abolished when the epigastric approach was used. Threshold elevation was not more frequent with epigastric electrodes (sutured to the right ventricle) than with the other techniques. Four per cent of the epigastric electrodes caused complications severe enough to require another mode of pacing, contrasting with 18 and 26 per cent, respectively, for the transvenous and transthoracic electrodes.
187个电极系统被植入158例连续患者体内——30个系统通过开胸植入，98个经静脉植入，52个经膈上腹部植入——并对长期结果进行了比较。开胸放置电极时并发症发生率很高（76%），延长了初次住院时间（33%），并需要频繁再次住院（56%）。经静脉电极的并发症发生率为39%（首次住院期间为16%，需要再次住院的为28%）。经膈上腹部电极的这些数字分别为15%、12%和6%。经静脉电极最常见的并发症是移位（15%）、溃疡和局部感染；采用上腹部途径时，所有这些并发症都消除了。与其他技术相比，经膈上腹部电极（缝合至右心室）阈值升高并不更常见。4%的经膈上腹部电极引起的并发症严重到需要采用另一种起搏方式，而经静脉和经胸电极分别为18%和26%。
