双腔起搏房室延迟时间对心功能的影响  

Effect of optimal AV delay of DDD pacing on cardiac function

作　　者：寿锡凌[1] 陈新义[1] 吉海鸣[1] 丁育增[2] 樊应书[1] 官功昌[1] 王芳云[1] 

机构地区：[1]陕西省人民医院心内科,西安市710068 [2]陕西省人民医院心B超室,西安市710068

出　　处：《心电学杂志》2005年第3期137-140,共4页Journal of Electrocardiology(China)

基　　金：陕西省社会发展攻关基金资助项目(编号2004K14-G5)

摘　　要：目的观察不同房室延迟(AVD)的双腔起搏对心脏收缩、舒张功能的影响及不同心功能状态下的优化AVD。方法测量20例心力衰竭患者及10例心功能正常者(对照组)不同房室延迟起搏的急性血流动力学效应,同时以脉冲多普勒超声心动描记术测量心脏收缩、舒张功能指标。结果心力衰竭组房室延迟在134±13、131±12、136±10ms起搏时,血流动力学指标及左心室收缩功能、右心室舒张功能指标较AVD基线穴100ms雪及250ms显著改善;140±17ms起搏时,左心室舒张功能指标较AVD基线及250ms显著改善。对照组AVD在162±14ms起搏时,血流动力学参数较AVD基线及250ms显著改善。结论优化AVD可即刻改善心力衰竭患者心脏收缩及舒张功能,优化AVD随心功能状态不同而改变。Objective To investigate immediate effect of different AV delay（AVD） during DDD pacing on cardiac systolic and diastolic function. Methods Hemodynamic parameters were measured by Swan-Ganz catheter and cardiac systolic and diastolic function were determined by 2dimension and pulse Doppler echocardiography under different AVD during DDD pacing in 20 patients with heart failure and 10 patients with normal heart function. Results Hemodynamic parameters, left ventricular systolic function and right ventricular diastolic function were significantly improved under AVD of 134±13,131±12 and 136±10ms, respectively, and left ventricular diastolic function was significantly improved under ADV of 140±17ms when compared to those under AVD of lOOms and 250ms. Left ventricular hemodynamic parameters were significantly improved under AVD of 162±14ms when compared to those under AVD of lOOms and 250ms in control group. Conclusion An optimum AVD during DDD pacing can improve cardiac systolic and diastolic function immediately in patients with CHF and it varies depending on cardiac function.

关 键 词：双腔起搏 心力衰竭 血流动力学 超声心动图描记术 优化房室延迟 心功能状态 房室延迟 延迟时间 多普勒超声心动描记术 心力衰竭患者 

分 类 号：R541.6[医药卫生—心血管疾病]