超声心动图评价右室双部位起搏近期疗效研究  

An Evaluation with Echocardiography on the Recent Clinical Effect of Right Ventricular Bifocal Pacing

作　　者：俞杉[1] 陈启旸[1] 陈欣[1] 夏旻[1] 张萍[1] 

机构地区：[1]贵州省人民医院心内科,贵州贵阳550002

出　　处：《贵阳医学院学报》2005年第6期504-506,共3页Journal of Guiyang Medical College

摘　　要：目的:用超声心动图观察右室双部位(RV-B i)起搏的临床效果。方法:患者8例,其中病窦综合征(SSS)5例,心房纤颤(A f)伴Ⅲ度房室传导阻滞(AVB)3例,患者均于术中完成右室心尖部(RVA)、右室流出道(RVOT)及RV-B i起搏,5例进行了永久RV-B i起搏。在同一起搏频率下用超声心动图测定RVA、RVOT及RV-B i起搏时的左室射血分数(EF)、短轴缩短率(FS)、每搏输出量(SV)和心输出量(CO),同时随访观察永久RV-B i起搏前后EF、FS、SV、CO和二尖瓣反流量的变化。结果:与RVA起搏相比,RV-B i起搏和RVOT起搏的EF、FS、SV及CO明显增高(P<0.01),其中又以RV-B i起搏时心功能为最佳;永久RV-B i起搏术后1周和3月后,患者心功能亦得到改善,EF、FS、SV和CO增加(P<0.05);二尖瓣最大瞬间反流面积亦较术前明显减少(P<0.05)。结论:RV-B i起搏可有效改善患者的近期心功能。Objective： To assess recent clinical effect of right ventricular bifocal （RV-Bi） pacing with echocardiography. Methods： A total of 8 patients were observed. Among them, 5 cases were sick sinus syndrome （SSS）, and 3 cases were atrial fibrillation （AF） accompanied by Ⅲ° atrioventricular block （AVB）. All the 8 patients accepted right ventricular apex （RVA） pacing, right ventricular outflow tract （RVOT） pacing and right ventricular bifocal pacing （RV-Bi）. 5 of them accepted RV-Bi permanent pacing. The ejection fraction （LVEF）, fractional shortening of the minor semi-axis （FS）, stroke index （SV） and cardiac output （CO） were measured by echocardiography at same pacing frequency on each pacing mode. Data including LVEF, FS, SV, CO and mitral regurgitation were respectively investigated in 1 week and 3 months after RV-Bi pacemakers implanted. Results： Compared with RVA pacing, the RVOT pacing and RV-Bi pacing increased significantly the LVEF, FS, SV and CO, and RV-Bi pacing was even more significantly effective on indices mentioned above. In 1 week and 3 month after RV-Bi pacing, the LVEF, FS and SV were still increasing （P 〈 0.05） and the mitral regurgitation reduced （P 〈 0.05）. Conclusion： RV-Bi pacing can significantly improve recent clinical cardiac function.

关 键 词：超声心动描记术 右室双部位 心脏起搏器 人工 心室功能 

分 类 号：R540.45[医药卫生—心血管疾病] R654.2[医药卫生—内科学]