个性化选择最佳心室起搏部位的临床研究  

Individualizing Selection of Optimal Cardiac Ventricular Pacing Position

作　　者：杨敏全[1] 朱燕[1] 周军[1] 张小忆[1] 顾锡华[1] 姜述斌[2] 许力舒[2] 

机构地区：[1]上海第二医科大学宝钢医院心内科,上海201900 [2]新疆维吾尔自治区人民医院心内科

出　　处：《上海第二医科大学学报》2005年第7期708-710,共3页Acta Universitatis Medicinalis Secondae Shanghai

基　　金：上海第二医科大学自然科学基金(04XJ2114)资助项目.

摘　　要：目的个性化选择心室永久起搏部位,预防心功能异常.方法 65例病态窦房结综合征、高度或Ⅲ度房室传导阻滞患者,心功能分级、左室射血分数(LVEF)及心胸比例基本正常,其中实验组32例,个性化永久起搏多部位筛选;对照组33例,单纯以右室流出道作为永久起搏点,比较两组患者起搏QRS波时限和形态、术前与术后6 ～ 36月的胸片、心脏超声心动图和NYHA分级等.结果两组患者年龄、性别、心律失常类型无显著差异(P>0.05),起搏QRS时限和形态、术后3年LVEF和心胸比例均有显著差异(P<0.05).结论在预防心功能异常方面,对于心功能、LVEF和心胸比例基本正常而需永久心室起搏的患者,个性化多部位筛选永久起搏可能优于单纯右室流出道起搏.ObjectiveTo select individually the permanent pacing position for preventing abnormal cardiac function.MethodsSixty-five patients with sick sinus syndrome(SSS), severe or grade atrioventricular block with basically normal cardiac function, left ventricle ejection fraction(LVEF) and cardiothoracic ratio were classified into experiment group(n=32) and control group (n=33). In experiment group,several pacing places were tested and compared before the optimal place was identified. In control group,only outflow tract of the right ventricle was (selected) as the permanent pacing position. The QRS duration and outline, X-rays of the chest, echocardiogram and NYHA grade before and 6~36 months after artificial pacing were observed in both groups.ResultsThere were no significant differences in sex, age, and arrhythmia(P>0.05). After artificial pacing, the QRS duration, LVEF and cardiothoracic ratio were significantly different between the two groups (P<0.05).ConclusionIn the application of permanent artificial pacing in patients with basically normal cardiac function, LVEF, and cardiothoracic ratio, individualizing the pacing position by screening several pacing areas of the right ventricle pacing is better in preventing abnormal cardiac function than the routine route though the outflow tract of the right ventricle as the solo pacing position.

关 键 词：心血管疾病 右室流出道起搏 个性化 起搏部位 

分 类 号：R541.7[医药卫生—心血管疾病]