右室双部位起搏的临床应用研究  

The study of clinical application of right ventricular bifocal pacing

作　　者：陈启旸 俞杉 陈欣 夏旻 张萍 

机构地区：[1]贵州省心血管病医院,贵阳550002

出　　处：《贵州医药》2005年第8期675-677,共3页Guizhou Medical Journal

摘　　要：目的对比研究右室双部位(RV-Bi)起搏、右室心尖部(RVA)起搏及右室流出道(RVOT) 起搏的QRS宽度(QRSd)、QRS电轴(QRSa)及心功能。方法8例患者于起搏器植入术中一次性完成研究,其中5例进行了永久性RV-Bi起搏并于术后3月重复术中研究。结果RV-Bi与RVOT起搏的QRSa相似,但与RVA起搏的QRSa明显不同;RV-Bi起搏的平均QRSd(148 ms)最窄,比RVA (191 ms)缩短43 ms(22.5%),比RVOT(174 ms)缩短26 ms(14.9%)。RV-Bi起搏时心功能最佳, 其平均射血分数、每搏量及心输出量比RVA起搏分别提高20%、22%及24%,比RVOT起搏分别提高10%、11%和10%。RVOT起搏采用普通心房J型电极,经3月随访,无一例脱位。结论RV-Bi起搏可改善心室的激动顺序及同步性,提高心功能,并具有手术简便、安全,并发症少及价格便宜的优点,适合临床应用。Objective To explore clinical application of right ventricular bifocal pacing. Methods The QRS duration（QRSd）, QRS axis（QRSa） and cardiac function were comparatively studied during right ventricular bifocal（RV-Bi） pacing, right ventricular apex（RVA） pacing and right ventricular outflow tract（RVOT） pacing. Results The studies had be completed by one time during pacemaker implantation operation in 5 of the 8 case underwent the permanent RV-Bi pacing and completed again the studies after 3 months of operation. ORSa of the RV-Bi and RVOT pacing was similar, but it was significant difference when compared with the RVA pacing. Average ORSd of RV-Bi pacing was narrowest （148 ms）, it has respectively shortened 43 ms（22. 5%） and 26ms（14.9%） when comparing with RVA（191 ms） and RVOT （174 ms） pacing. The cardiac function of RV-Bi pacing was the finest, it＇s EF,SV and CO have raised 20%,22% and 24% . Conclusion It has the merits of operating simplification,safety, less complications and cheep, suiting for clinical application.

关 键 词：右室双部位起搏 QRS波宽度 QRS波电轴 心功能 

分 类 号：R318.11[医药卫生—生物医学工程]