我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

右室室间隔起搏与心尖部起搏对心功能影响的比较(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2009年第4期
页码:
528-530
栏目:
临床研究
出版日期:
2009-06-25

文章信息/Info

Title:
Comparison of cardiac function between right ventricular septal pacing and right ventricular apex pacing
作者:
韦彩雯; 毛家亮; 何奔; 郝静
上海交通大学医学院附属仁济医院心内科，上海 200025
Author(s):
WEI Cai-wen;  MAO Jia-liang;  HE Ben;  HAO Jing
Department of Cardiology, Renji Hospital, Medical School, Shanghai Jiaotong University, Shanghai 200025, China
关键词:
右室流出道; 室间隔; 右室心尖部; 起搏
Keywords:
right ventricular out flow tract;  right ventricular septal;  right ventricular apex;  pacing
分类号:
R541.7
DOI:
-
文献标识码:
A
摘要:
目的 比较右室室间隔起搏与心尖部起搏对患者心功能的影响。方法 180例患者随机分为右室室间隔部起搏组（n=98例）和右室心尖起搏组（n=82例）。比较两组患者术前与术后第18个月心脏彩超的变化。 结果 间隔组患者的左室射血分数（LVEF）较术前显著提高 ［（66±8）% vs （69±9）%,P<0.01］，心搏出量（SV）较术前显著提高［（83±15）ml vs (87±12）ml,P<0.01］，左室舒张末期内径(LVEDD)缩小未达显著水平［(52±5)mm vs (51±5)mm］,左室收缩末期内径(LVESD)无明显变化［(31±5)mm vs (31±5)mm］,而心尖组LVEF显著降低［(68±7)% vs (63±8)%,P<0.01］，SV显著减少了7 ml［(87±16)ml vs (80±10)ml,P<0.01］，LVEDD显著增大3 mm［(50±6)mm vs (53±7)mm，P<0.01］，LVESD显著增大 ［（30±5）mm vs (32±6）mm，P<0.05］，两组患者各观察指标同期比较术前无统计学意义,术后18个月LVEF差异有非常显著统计学意义（P<0.01），SV差异有统计学意义（P<0.05）。结论 右室室间隔起搏较右室心尖部起搏更利于起搏器植入患者的心功能保护。
Abstract:
AIM: To compare the cardiac function between right ventricular septal pacing and right ventricular apex pacing. METHODS: A total of 180 cases were randomly divided into ventricular septal pacing group (n=98 cases) and apex pacing group (n=82). Changes in the echocardiogram of the two groups were compared before surgery and 1.5 years after surgery. RESULTS: Left ventricular ejection fraction (LVEF) in septal group increased ［(66±8)% vs.(69±9)%, P<0.01］, stroke volume (SV) increased ［(83±1)ml vs.(87±12)ml, P<0.01］, left ventricular end-diastolic diameter (LVEDD) decreased ［(52±5)mm vs.(51±5)mm］, and no significant change was found in left ventricular end-systolic diameter (LVESD) ［(31±5)mm vs.(31±5)mm］. In apex group, LVEF significantly decreased ［(68±7)% vs.(63±8)%, P<0.01］, SV significantly decreased ［(87±16) ml vs.(80±10) ml, P<0.01］, and a significant increase was found in LVEDD ［(50±6)mm vs.(53±7)mm, P<0.01］ and in LVESD ［(30±5)mm vs.(32±6)mm, P<0.05］. Eighteen months after operation, LVEF (P<0.01) and SV (P<0.05) were significantly different between groups. Pre- and postoperative difference between groups was statistically significant (P<0.05). CONCLUSION: Ventricular septal pacing is superior to right ventricular apex pacing in improving cardiac function in patients with pacemaker implant.

参考文献/References

［1］McGavigan AD, Roberts-Thomson KC, Hillock RJ, et al. Right ventricular outflow tract pacing: Radiographic and electrocardiographic correlates of lead position［J］. Pacing Clin Electrophysiol, 2006, 29 (10):1063-1068.

［2］ Richard J, Hillock MB. The right ventricular outflow tract: A comparative study of septal, anterior wall, and free wall pacing［J］. Pacing Clin Electrophysiol, 2007, 30(8):942-947.

［3］ Vlay SC. Right ventricular outflow tract pacing: practical and beneficial. A 9-Year experience of 460 consecutive implants［J］. Pacing Clin Electrophysiol, 2006, 29(10):1055-1062.

［4］ 毛家亮,郝静,张琪,等. 右室流出道室间隔主动电极和右室心尖部被动电极的对照研究［J］. 中国心脏起搏与心电生理杂志, 2007, 21(3):203-205.

［5］ 汪芳,张建军,金炜,等. 采用主动固定电极导线行右室流出道间隔部起搏的临床应用［J］. 中国心脏起搏与心电生理杂志, 2006, 20(2):151.

［6］ Bakker PF, Meijburg HW, de Vries JW, et al. Biventricular pacing in end-stage heart failure improves functional capacity and left ventricular function［J］. J Interv Card Electrophysiol, 2000, 4(2):395-404.

［7］ Thambo JB, Bordachar P, Garrigue S, et al. Detrimental ventricular remodeling in patients with congenital complete heart block and chronic right ventricular apical pacing［J］. Circulation, 2004, 110(25):3766-3772.

［8］ Schwaab B, kindermann M, frohlig G, et al. Septal lead implantation for the reduction of paced QRS duration using passive fixation leads［J］. Pacing Clin Electrophysiol, 2001, 24(1):28-33.

［9］ 华伟,王方正,张澍,等. 双心室起搏治疗充血性心力衰竭的血流动力学观察［J］. 中华心律失常学杂志, 2000, 4(2):90-93.

［10］Muto C, Ottaviano L, Canciello M, et al. Effect of pacing the right ventricular mid-septum tract in patients with permanent atrial fibrillationand low ejection fraction［J］. J Cardiovasc Electrophysiol, 2007, 18(10):1032-1036.

备注/Memo

备注/Memo:
收稿日期：2008-9-24.通讯作者：毛家亮，主任医师，教授，博士，主要从事心脏起搏及心力衰竭、心脏神经症的研究Email:maoj19@yahoo.com.cn 作者简介：韦彩雯，住院医师，硕士生Email:wenzi636@yahoo.com.cn
更新日期/Last Update: 2009-06-15