右室流出道室间隔起搏临床观察.docVIP

右室流出道室间隔起搏临床观察 　　【摘要】目的 研究探讨右室流出道（RVOT）室间隔与右室心尖部（RVA）起搏方式差异，分析RVOT室间隔起搏的应用价值。方法 回顾性分析本院2012年7月～2014年7月收治的缓慢心律失常患者89例的临床资料，按照起搏器植入方式不同分为观察组与对照组，其中观察组45例，采用主动螺旋固定电极行RVOT室间隔起搏，对照组44例，采用被动翼状固定电极经RVA起搏，对两组患者植入起搏器前后心室电活动、R波宽窄以及心功能情况等。结果 全部患者均成功植入，观察组患者QRS波时限比较中，术后4周及半年后均明显窄于对照组，差异有统计学意义（t=5.2600，P0.05）；对照组患者在植入手术时与术后半年相比较，LVEDD、LVEF指标差异均有统计学意义（t=3.3949，P0.05）。结论 使用主动螺旋固定电极行RVOT室间隔起搏符合生理性起搏方式，对患者正常心脏构造无过度影响，安全可靠。 　　【关键词】RVOT；室间隔；主动电极；心功能 　　【中图分类号】R54 【文献标识码】A 【文章编号】ISSN.2095-6681.2015.06.0.03 　　Clinical observation of ventricular septal pacing in right ventricular outflow tract 　　FENG Sheng-hong，WANG Sheng-ping，FENG Yong-sheng，REN Jing 　　（Dazhou，Chinese and Western Medicine Hospital Cardiovascular Department of internal medicine，Sichuan Dazhou 635000，China） 　　【Abstract】Objective To investigate right ventricular outflow Road （RVOT）interventricular septum and right ventricular apex Department（RVA）pacing differences，analysis of the right ventricular outflow tract septal pacing application value.Methods A retrospective analysis of our hospital in 2012 July 2014 in July from 89 cases of slow arrhythmia in patients with clinical data，in accordance with the pacemaker implantation were divided into observation group and control group，the observation group（45 cases），using active screw fixed electrode RVOT ventricular septal pacing and 44 cases in the control group，using fixed tined electrode by RVA pacing，before and after the two groups of patients implanted pacemaker ventricular electrical activity，R wave width and heart function situation.Results All patients were successfully implanted in observed group of patients with QRS wave duration，postoperative 4 weeks and 6 months later were significantly narrower than that of the control group（t=5.2600，P 　　【Key word】Right ventricular outflow tract；Room interval；Active point；Cardiac function 　　当前国内外学者研究统计，心室起搏患者发生心衰、房颤等症状的发生率呈逐年上升趋势，经多项大型临床研究证实RVA起搏会对患者造成左束支传导阻滞，导致心脏功能受损[1-2]。由于RVA起搏技术运用便捷、植入快捷、电极不易脱落等特点而广泛应用与临床心室起搏治疗。不过RVA起搏也存