单腔起搏和双腔起搏治疗高度房室阻滞的比较  

Single-chamber versus dual-chamber pacing for high-grade atrioventricular block

作　　者：Toff W. D. Camm A. J. Skehan J. D. 姜朝晖 

机构地区：[1]Dr. Department of Cardiovascular Sciences, University of Leicester, Glenfield Hospital, Groby Rd, Leicester LE3 9QP, United Kingdom

出　　处：《世界核心医学期刊文摘（心脏病学分册）》2006年第1期20-21,共2页

摘　　要：BACKGROUND:In the treatment of atrioventricular block, dual-chamber cardiac pacing is thought to confer a clinical benefit as compared with single-chamber ventricular pacing, but the supporting evidence is mainly from retrospective studies. Uncertainty persists regarding the true benefits of dual-chamber pacing, particularly in the elderly, in whom it is used less often than in younger patients. METHODS:In a multicenter, randomized, parallel-group trial, 2021 patients 70 years of age or older who were undergoing their first pacemaker implant for high-grade atrioventricular block were randomly assigned to receive a single-chamber ventricular pacemaker(1009 patients) or a dual-chamber pacemaker(1012 patients).In the single chamber group, patients were randomly assigned to receive either fixed-rate pacing(504 patients) or rate-adaptive pacing(505 patients). The primary outcome was death from all causes. Secondary outcomes included atrial fibrillation, heart failure, and a composite of stroke, transient ischemic attack, or other thromboembolism. RESULTS:The median follow-up period was 4.6 years for mortality and 3 years for other cardiovascular events. The mean annual mortality rate was 7.2 percent in the single-chamber group and 7.4 percent in the dual-chamber group(hazard ratio, 0.96; 95 percent confidence interval, 0.83 to 1.11). We found no significant differences between the group with single-chamber pacing and that with dual-chamber pacing in the rates of atrial fibrillation, heart failure, or a composite of stroke, transient ischemic attack, or other thromboembolism. CONCLUSIONS:In elderly patients with high-grade atrioventricular block, the pacing mode does not influence the rate of death from all causes during the first five years or the incidence of cardiovascular events during the first three years after implantation of a pacemaker.BACKGROUND： In the treatment of atrioventricular block, dual-chamber cardiac pacing is thought to confer a clinical benefit as compared with single-chamber ventricular pacing, but the supporting evidence is mainly from retrospective studies. Uncertainty persists regarding the true benefits of dual-chamber pacing, particularly in the elderly, in whom it is used less often than in younger patients. METHODS： In a muhicenter, randomized, parallel-group trial, 2021 patients 70 years of age or older who were undergoing their first pacemaker implant for high-grade atrioventricular block were randomly assigned to receive a single-chamber ventricular pacemaker（1009 patients） or a dual-chamber pacemaker（1012 patients） .

关 键 词：双腔起搏治疗 高度房室阻滞 单腔起搏 频率适应性 年轻患者 心室起搏 房室传导阻滞 随机分配 植入起搏器 平行试验 

分 类 号：R542.205[医药卫生—心血管疾病] R541.76[医药卫生—内科学]