右心室不同起搏部位对起搏器植入患者心功能及远-内科急危重症杂志.DOCVIP

右心室不同起搏部位对起搏器植入患者心功能及远期预后的影响 唐婧,刘燕 （四川省内江第一人民医院心血管内科，四川内641000） 【摘要】 目的 探究右室间隔部(RVS)起搏与右室心尖部(RVA)对起搏器植入患者心功能及远期预后的影响。方法 选取299例于2007年1月至2012年5月入我院诊治的患者，所有患者均因房室传导阻滞或窦房结功能不全导致心律失常而接受起搏器植入治疗。根据患者起搏模式的不同，分成DDD起搏模式组和VVI起搏模式组，再根据心室电极固定部位的不同，将所有患者分为2组，RVS起搏组与RVA起搏组，收集整理不同起搏模式下2组患者术前、术后2年左室收缩末期内径（LVESD）、左室舒张期内径（LVEDD）、左室内径（LAD）、左室射血分数（LVEF）等超声参数，术后2年新发房颤比例、心衰发病住院比例等临床资料，对比分析2组患者的心功能及远期预后与起搏部位的关系。结果 与RVA起搏组相比，RVS起搏组的术后2年LVESD、LVEDD明显减小，LVEF显著上升，心衰发病住院比例较小，差异具有统计学意义；术后2年LAD、新发房颤比例无明显不同，差异无统计学意义。结论 在不同起搏模式下，与RVA起搏方式相比，RVS起搏部位更靠近生理起搏部位，能减少对患者心功能的影响，改善患者远期预后。 【关键词】右心室；起搏部位；心律失常；心功能；预后 The effect of pacemaker Implantation on heart function and further outcome for patients with Different Pacing Site?on right ventricular TANG-Jing,LIU-Yan (TheNeijiang first peoples Hospital of Sichuan Province, Neijiang641000) 【Abstract】ObjectiveMethod?299 patients were selected?from January 2007?to?May 2012?who lived in the department of cardiology of our hospital. All the patients?received pacemaker implantation because of arrhythmia caused by atrioventricular block?or?sinus node dysfunction. According to the pacing mode, the patients were divided into the DDD pacing mode group and the VVI pacing mode group. Then according to the pacing site, these patients were divided into two groups,: the RVS group and the RVA group. Then collect left ventricular end systolic diameter (LVESD), left ventricular diastolic (LVEDD), left atrial diameter (LAD), left ventricular ejection fraction (LVEF) before and after 2 years of the surgery, and the number of new-onset AF and hospital for heart failure of groups. Then find the relationship between the pacing part and the change of heart function and outcome. Result Compared to the RVA group, LVESD and LVEDD after two years of RVS group are significantly smaller, LVEF and the number of new-onset AF of RVS group are significantly higher than RVA group(P＜0.05); LAD and the number of hospital for heart failure of RVS group didn’t change significantly(P＞0.05)