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《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2015年第2期

页码:

169-171

栏目:

临床研究

出版日期:

2014-10-25

文章信息/Info

Title:

Association of different right ventricular apical pacing ratios and cardiac functions

作者:

刘晓辉; 张 博; 于晓峰; 谭 虹

(大连市友谊医院心内科,辽宁 大连 116001)

Author(s):

LIU Xiao-hui;  ZHANG Bo;  YU Xiao-feng;  TAN Hong

(Department of Cardiology, Dalian Friendship Hospital, Dalian 116001, Liaoning, China)

关键词:

心脏起搏部位; 起搏比率; 心脏结构与心功能

Keywords:

Cardiac pacing site;  percentage of ventricular pacing;  cardiac structure and function

分类号:

R541.7

DOI:

-

文献标识码:

A

摘要:

目的:探讨传统右室心尖部起搏与右室流出道间隔起搏对心功能的影响，以及右室心尖部不同起搏比例与左室大小的关系。方法:66例缓慢性心律失常患者行起搏治疗：46例为右室心尖部起搏，20例为中下位室间隔起搏，随访12个月，心脏超声评价术前、半年及1年的左房及左室内径、左室射血分数；对心尖部起搏组按心室起搏比率分为≥30%、<30%两组，同样心脏超声评价左房及左室内径、左室射血分数。结果:右心室心尖部组及右心室室间隔组，在手术前、手术后6个月及12个月其左心房内径、左心室舒张末内径及左室射血分数均无显著差别。心尖部起搏比率≥30%组与<30%组间左心房内径、左室射血分数未见显著区别，而左心室在半年及1年可见左心室舒张末径变化有显著差异，随着起搏比率增加，左心室舒张末内径增大。结论:右室起搏1年，起搏部位对左心结构及功能影响无统计学意义；右室心尖部高心室起搏比率（≥30%）可引起左心室舒张末内径的增大。

Abstract:

AIM:To investigate the effects of traditional right ventricular apical pacing and right ventricular outflow tract septum pacing on cardiac functions and the relationship between different right ventricular apical pacing ratio and left ventricular size. METHODS: Sixty-six cases of patients with arrhythmia were treated with slow pacing therapy, 46 cases with right ventricular apical pacing and 20 cases with ventricular septal pacing. Left atrial and left ventricular internal diameters and left ventricular ejection fraction were evaluated by ultrasound before surgery as well as 6 and 12 months postoperatively. Right ventricular apical pacing rates were divided into two groups, with pacing rate ≥30% and <30%, and left atrial and left ventricular internal diameter and left ventricular ejection fraction were also examined. RESULTS: No significance differences were observed in left atrial diameter, left ventricular end-diastolic diameter and left ventricular ejection fraction between right ventricular apex group and right ventricular septal group before surgery as well as 6 months and 12 months postoperatively. There were no significant differences in left atrial diameter and left ventricular ejection fraction between groups of apical pacing rates ≥30% and <30%. Howeveer, significant difference was found in left ventricular end-diastolic ventricular diameter changes 6 and 12 months postoperatively and the left ventricular end-diastolic diameter increased with the increases of pacing rate. CONCLUSION: There is no significant difference in left ventricular structure and function 12 months after surgery and right ventricular apical pacing with a high ratio (≥30%) can cause an increase in left ventricular end-diastolic diameter.

参考文献/References

[1]李 萍,石 泉,程晓曙,等.右室流出道间隔部和心尖部起搏对心功能和重构的影响[J].中国心脏起搏与心电生理杂志,2011,(1):31-33.
[2]Wang F,Shi H,Sun Y,et al.Right ventricular outflow pacing induces less regional wall motion abnormalities in the left ventricle compared with apical pacing[J].Europace March,2012,14(3):351-357.
[3]于海波,王冬梅,臧红云,等.右心室间隔部起搏与心尖部起搏对起搏依赖患者心功能的长期影响[J].实用医学杂志,2010,26(2):236-237.
[4]Nikoo MH,Ghaedian MM,Kafi M,et al.Effects of right ventricular septal versus apical pacing on plasma natriuretic peptide levels[J].J Cardiovasc Dis Res,2011,2(2):104-109.
[5]陈 乔,傅春江,杨 立,等.右室高位间隔部与心尖部VVI起搏对心功能的影响[J].中国心脏起搏与心电生理杂志,2012,26(1):39-40.
[6]Domenichini G,Sunthorn H,Fleury E,et al.Pacing of the interventricular septum versus the right ventricular apex:a prospective, randomized study[J].Eur J Intern Med,2012,23(7):621-627.

备注/Memo

备注/Memo:

收稿日期：2014-05-21.
作者简介：刘晓辉，主任医师，硕士Email：liuxiaohui96@163.com

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更新日期/Last Update: 2014-11-18