右室多部位起搏的QRS宽度与心功能的对比研究  

Comparison on QRS duration and cardiac function during Multi-site pacing in the right ventricular

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,贵阳550002

出　　处：《中国医师进修杂志（内科版）》2006年第1期31-32,共2页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较右室心尖部(RVA)、右室流出道(RVOT)和右室双部位(RV-Bi)起搏的QRS宽度和对心功能的影响。方法8例患者分别于术中行RVA、RVOT及RV-Bi起搏,在同一起搏频率下测定每搏量(SV)、射血分数(EF)、心输出量(CO)、QRS宽度(QRSd)和电轴(QRSa)。结果与RVA起搏相比,RVOT和RV-Bi起搏的EF、SV和CO均增加,以RV-Bi增加明显(P<0.01);RV-Bi和RVOT起搏较RVA起搏的QRSd分别缩短43ms和17ms,而RV-Bi则比RVOT缩短26ms,差异均有统计学意义(P<0.05或P<0.01)。结论比较三种起搏方式,RV-Bi起搏的QRSd最窄,心功能最优,RVOT起搏次之,RVA起搏最差。Objective To assess the effect of ORS duration （QRSd） and cardiac function during right ventricular apex（RVA） pacing,fight ventricular outflow tract （RVOT） pacing and right ventricular bifocal （RV- Bi） pacing. Methods Eight patients underwent RVA pacing, RVOT pacing and RV- Bi pacing during pacemaker implantation operation. The ejection fraction （EF）, stroke index （SV）, cardiac output（CO）, QRS QRSd, QRS axis （QRSa） were measttred after each pacing at the same pacing frequency. Results Compared with RVA pacing, the EF,SV and CO increased during RVOT pacing and RV - Bi pacing. The cardiac function of RV - Bi pacing was significantly increased （ P 〈 0.01 ）. The QRSd of RV - Bi pacing and RVOT pacing were shortened by 43 ms and 17 ms compared with that of RVA pacing. The QRSd of RV- Bi pacing was shortened by 26 ms compared with that of RVOT pacing （P 〈 0.05 or P 〈 0.01 ）. Conclusion In the three pacing style, the QRSd during RV - Bi pacing is the narrowest and the cardiac function is the best. RVOT pacing is the second place and RVA pacing is the worst.

关 键 词：多部位心脏起搏 QRS宽度 心功能 心输出量 射血分数 

分 类 号：R654.2[医药卫生—外科学] R540.41[医药卫生—临床医学]