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安装心室按需型起搏器,起搏电极一般放置于右室心尖部,在此部位起搏阈值低,易固定。我们遇到一例患者在起搏器安装过程中,心尖部起搏始终达不到理想要求,最后将起搏导管电极放置在右室流出道室间隔部位,起搏良好。报道如下。患者女性,68岁。因胸闷、心悸、发作性晕厥住院。查心率最慢达35次/分,律整,各瓣膜区未闻杂音,心界不大。X线胸片正侧斜位心外形均正常。心电图示Ⅲ度房室传导阻滞,心室逸搏心律。静脉给予异丙基肾上腺素维持心率同时安装VVI型起搏器。
On-demand ventricular pacemaker installation, pacing electrodes are generally placed in the right apex of the apex, in this part of the low pacing threshold, easy to fix. We encountered a patient in the pacemaker installation process, the apex pacing is always less than the desired requirements, and finally placed in the right ventricular pacing catheter outflow tract ventricular septal site pacing good. Reported as follows. Patient female, 68 years old. Due to chest tightness, palpitations, episodes of syncope hospitalization. Check the heart rate of the slowest of up to 35 beats / min, law, the valve area did not smell noise, the heart is not big. Positive X-ray chest oblique side shape are normal. ECG third degree atrioventricular block, ventricular escape rhythm. Intravenous isoproterenol to maintain heart rate while installing the VVI pacemaker.