体表心电图在优化双腔起搏器房室间期中的价值  

The Application of Surface Electrocardiography in Optimizing Atrioventricular Delay for Dual-Chamber Pacemaker

作　　者：刘志敏[1] 陈柯萍[1] 崔琪琼[2] 孙欣[2] 张澍[1] 

机构地区：[1]中国医学科学院、中国协和医科大学、心血管病研究所、阜外心血管病医院、心律失常诊治中心,北京市100037 [2]中国医学科学院超声科

出　　处：《中国循环杂志》2008年第1期30-32,共3页Chinese Circulation Journal

摘　　要：目的:探索以体表心电图优化双腔起搏器房室间期的方法,以期找到一种简便易行,又能获得良好血流动力学效果的方法。方法:选择31例因Ⅲ度房室传导阻滞植入双腔起搏器的患者,出院前行12导联心电图检查。自身P波结束到起搏的QRS波波峰或波谷的时间为100 ms作为心电图优化的最适房室间期。然后行超声心动图及组织多普勒检查,比较最适房室间期与出厂值的血流动力学变化。所有患者的窦房结功能均正常,优化的房室间期为感知的房室间期。结果:经心电图优化房室间期后,心肌做功指数明显减小,心肌收缩及舒张功能明显改善。结论:根据体表心电图优化双腔起搏器房室间期简便可行,可获得良好的血流动力学效果,具有广泛的临床实用价值。To investigate the application of surface electrocardiography in optimizing sensed atrioventricular delay（SAV）for dual-chamber pacemaker, Methods ： DDD pacemakers were implanted in 31 patiments with complete atrioventricular block. Optimal SAV was achieved by programming a delay of 100 ms from the end of sensed P wave to peak/nadir of the paced ventricular complex. Myocardial performance index （MPI） and the time, to peak systolic velocity（Ts）and time to peak early/late diastolic velocity of septal and left lateral were measured, Results ： Optimization of SAV resulted in a relative MPI decrease and systolic and diastolic pcrfermance was significantly improved compared to nominal SAV delay（ 150 ms）, Conclusions ： Optimization of SAV delay by surface ECG is a simple method to improve left vcntricular systolic and diastolic function in patients with DDD pacemakers.

关 键 词：双腔起搏器 体表心电图 房室间期 

分 类 号：R540.41[医药卫生—心血管疾病]