Nghiên cứu đặc điểm cấy điện cực thất trong tạo nhịp tim tại mỏm và vùng vách đường ra thất phải

Abstract

Objective: To investigate ventricular lead performance, safety and change in pacing parameters of right ventricular outflow tract and apical pacing at 12 months follow-up. Subject and method: 115 patients were enrolled in this study including 50 patients with right ventricular apex pacing (as RVA group) and 65 patients with right ventricular outflow tract pacing subjects (as RVOT group). Ventricular lead performance, pacing parameters (Threshold, lead impedance, R-wave sensing, slewrate and current of injury) and complications were compared between groups at implantation and 12 months follow-up. Result: Fluoroscopy duration time to access suitable position with acceptable parameters for pacing were shown higher in RVOT group comparing to RVA group (12.75 ± 4.2 minutes vs 8.24 ± 3.5 minutes). Success was achieved in 94% with RVA placement and 92.3% in the RVOT group, p>0.05. There were no significant differences between the RVOT and RVA groups in the mean stimulation threshold, either at implantation or during 12-month follow-up. In the RVOT group, acute threshold rise in one patient. In the RVA group, acute threshold rise in one patient and pericardial effusion in two patients; no periprocedural death occurred in either group. Conclusion: This study demonstrated a high success rate for the implantation of ventricular lead with a low complication rate. Acute and chronic thresholds associated with RVOT pacing are similar to those observed with apical pacing.