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右室单双部位起搏对心功能和QRS宽度的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2003年第1期
页码:
25-27
栏目:
临床研究
出版日期:
2003-01-01

文章信息/Info

Title:
The effects of right ventricular bifocal pacing on cardiac function and QRS duration
作者:
朱参战; 张全发; 崔长琮; 薛小临; 傅文; 刘维维; 刘引会; 徐琳
西安交通大学第一医院心内科,陕西 西安710061
Author(s):
ZHU Can-zhan; ZHANG Quan-fa; CUI Chang-zong; XUE Xiao-lin; FU Wen; LIU Wei-wei; LIU Yin-hui; XU Ling
Department of Cardiology,The First Hospital of Xi'an Jiao Tong University, Xi'an Shaanxi 710061,China
关键词:
多部位心脏起搏; 心功能; QRS宽度
Keywords:
multi-site cardiac pacing; cardiac function; QRS duration
分类号:
R318.1
DOI:
-
文献标识码:
A
摘要:
目的:比较右室双部位(RV-Bi)起搏与右室心尖部(RVA)、右室流出道(RVOT)起搏对心功能的影响及RQS宽度的变化。方法:患者15(男10,女5)例,年龄66±6岁,其中病态窦房结综合征(SSS)8例,三度房室阻滞(Ⅲ?AVB)7例。分别行RVA,RVOT,RV-Bi起搏(VVI,60～90·min-1,测定心排出量(CO)和心脏指数(CI)、平均肺动脉压(mPAP)和肺毛细血管嵌顿压(RCWP),QRS宽度(QRSd)和电轴(QRSa)。结果:①与RVA起搏(CO:4.16±0.51L/min;CI:2.39±0.34L·min-1·m-2;PCWP:17.5±3.7mm Hg)相比,RVOT起搏(CO:4.42±0.63L/min;CI:2.57±0.45L·min-1·m-2;PCWP:14.9±3.7mmHg)和RV-Bi起搏(CO:4.77±0.69L/min;CI:2.76±0.53L·min-1·m-2;PCWP:13.7±3.1mmHg)CO,CI显著增加、PCWP明显降低(P<0.05～0.01);②RV-Bi起搏较RVOT起搏的CO,CI增高(P<0.01)而PCWP降低(P<0.05);③RVOT,RV-Bi起搏的QRSd(分别为128±11ms;111±16ms)较RVA起搏时(146±18ms)显著缩短(P<0.05～0.01);RV-Bi起搏又比RVOT起搏明显缩短(P<0.01)。结论:右室双部位(RV-Bi)起搏的心功能明显优于RVA,RVOT等单部位起搏;右室双部位起搏的QRSd也比右室单部位起搏明显缩短。
Abstract:
AIM: To assess the potential value of right ventricular bifocal(RV-Bi) pacing.METHODS:15pts(66±6a,10men;8SSS,7Ⅲ?AVB)underwent pacemaker implantation,right ventricular apex(RVA), outflowtract (RVOT)and RV-Bi pacingatrate 60～90·min-1in VVI mode prior to permanent pacemaker implantation.The CO,CI,mPAP and PCWP were measured bySwan-Ganz thermodilution catheter 5 min after each pacing.ECG was recorded at 25 mm/s and 50 mm/s simultaneously for QRS duration(QRSd).ESULTS:Compared with RVA pacing(CO:4.16±0.51L/min;CI:2.39±0.34L·min-1·m-2;PCWP:17.5±3.7mm Hg),the CO and CI increase and the PCWP decreases significantly during RVOT pacing(CO:4.42±0.63L/min;CI:2.57±0.45L·min-1·m-2;PCWP:14.9±3.7mmHg)and RV-Bi(CO:4.77±0.69L/min;CI:2.76±0.53L·min-1·m-2;PCWP:13.7±3.1mm Hg),P<0.05～0.01.②The CO and CI of RV-Bi pacing were higher than those of RVOT pacing(P<0.01),the PCWP was lower than that of RVOT pacing (P<0.05).③The QRSds of RVOT(128±11ms)and RV-Bi pacings(111±16ms)were significant shortened compared with that of RVA pacing(146±18ms),P<0.05～ 0.01,and the QRSd of RV-Bi pacing was the shortest.CONCLUSION:The cardiac function of RV-Bi pacing was much better than those of RVA and RVOT pacings.The QRSd during RV-Bi pacing was significantly shorter than those of RVA and RVOT pacings.

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备注/Memo

备注/Memo:
收稿日期：2001-06-14.
更新日期/Last Update: 2003-01-01