右室间隔起搏与心尖部起搏对完全性房室传导阻滞患者心功能影响的比较

韩 凯; 张海成; 肖世南; 董卫锋; 鲁莉萍

右室间隔起搏与心尖部起搏对完全性房室传导阻滞患者心功能影响的比较

Effect of right ventricular septal pacing and right ventricular apical pacing on heart functions in patients with complete atrioventricular block: a comparative study

摘要

摘要: 目的:初步探讨右室间隔起搏(RVSP)和右室心尖部起搏( RVAP)对完全房室传导阻滞( CAVB) 患者心功能的影响。方法:87例因CAVB植入起搏器的患者, 其中45例行RVSP术(RVSP组)，42例行RVAP术(RVAP组)，分别对术前及术后6、12和18个月，患者的QRS波时限、左室舒张末内径（LVEDD）、左室射血分数（LVEF）、每搏量（SV）、心脏指数（CI）、加速度指数（ACI）进行检查比较。结果:所有患者均完成12个月随访, 79例完成18个月随访。术后RVAP组QRS波时限较RVSP组明显增宽(P<0.05)，术后12个月RVAP组LVEF、SV、ACI均较RVSP组明显降低(P<0.05)，术后18个月RVAP组LVEDD较RVSP组明显增大(P<0.05)，RVAP组CI均较RVSP组降低，但尚未达到显著性差异。结论:RVSP较RVAP有利于CAVB患者心功能的保护。

Abstract: AIM:To compare the effects of right ventricular septal pacing (RVSP) and right ventricular apical pacing (RVAP) on heart functions in patients with complete atrioventricular block (CAVB). METHODS: Eighty-seven CAVB patients with implanted pacemakers were enrolled in this study. Patients were divided into RVSP group (n=45) and RVAP group (n=42). QRS duration, LVEDD, LVEF, SV, CI and ACI were measured before implantation and 6, 12 and 18 months after implantation. RESULTS: QRS duration in RVAP group was longer than in RVSP group (P<0.05). LVEF, SV and ACI in RVAP group decreased compared with those in RVSP group 12 months after implantation (P<0.05). LVEDD in RVAP group increased compared with that in RVSP group 18 months after implantation (P<0.05). CI in RVAP group decreased, but no significant difference was found between groups 18 months after implantation. CONCLUSION: Right ventricular septal pacing (RVSP) is good in protecting cardiac function in patients with CAVB compared with right ventricular apical pacing (RVAP).

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