摘要 为探讨起搏器安置术中电极刺激所致室性心律失常与电极定位成败关系，对159例患者安装永久起搏器(VVI)时出现的451例次刺激性室性心律失常进行分析。按刺激性室性波数目和类型分少发组、多发组及高发组，并比较各组达满意起搏参数值例次数。发现少发组刺激性室性波265例次无一例次达满意起搏参数值；多发组74例次中达满意起搏参数值为47例次(64%)；高发组112例次全部达满意起搏参数值。多发组、高发组分别与少发组比较差异有显著性(P均<0.01)。表明起搏电极定位成败与刺激性室性波多少有关，而与电极所处心室位置无关；认为刺激性室性波属心肌应激正常生理反应，是预测心室起搏定位的一项简便、可靠的监测指标。

He Zhonghai,Xu Jianzhong

    (Department of Cardiology,Changnin District Center Hospital,Shanghai,200051)

Abstract To evaluate the relation between ventricular arrhythmias stimulated by pacing lead and suitable site of pacing lead,451 stimulated ventricular arrhythmias (SVA) among 159 patients with a pacemaker of VVI mode were analyzed.According to the number and the type of the SVA,they were divided into three groups:low,middle and high morbidity.In 265 SVAs of the low group,nobody reached nice pacing parameters,but 47 out of 74 SVA in the middle group (47/74;64%) and all 112 SVAs of high group reached.Compared the low groups with the other two groups respectively,the difference was significant (P<0.001).Significant positive correlation was not found between the number of SVA and pacing lead site (P>0.05).Conclusion:The SVA may be considered to be a normal physiologcal reaction of myocardiac cells to extra-stimulations.So we suggest that monitoring SVA while implanting pacing lead in ventricle may be a simple,useful method to evaluate suitable ventricular site of the pacing lead.

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