超声心动图对不同频率AAI及VVI起搏的血流动力学研究  

Echocardiographic study of the hemodynamics of AAI and VVI pacing

作　　者：沈建秀 顾复生[1] 王安安[1] 宁静[1] 刘庆山[1] 

机构地区：[1]北京友谊医院心内科

出　　处：《中华心血管病杂志》1998年第2期126-128,共3页Chinese Journal of Cardiology

摘　　要：目的本研究的目的在于评价不同频率ＡＡＩ及ＶＶＩ起搏的血流动力学效果，探索最佳起搏频率范围，比较ＡＡＩ及ＶＶＩ起搏的血流动力学效果。方法３７例植入永久心脏起搏器的患者分为两组，ＡＡＩ组１７例，ＶＶＩ组２０例。程控起搏频率从５０～１００次／分，以超声心动图评价其血流动力学效果。结果在ＡＡＩ起搏组，７０次／分起搏的心排血量（ＣＯ）高于５０及６０次／分起搏（Ｐ＜０．０５）。８０～９０次／分起搏的ＣＯ变化无显著性差异。１００次／分起搏的ＣＯ低于９０次／分起搏。在ＶＶＩ起搏组，起搏频率超过８０次／分时，ＣＯ不再增高，１１０次／分起搏的ＣＯ甚至低于７０次／分起搏，左室射血分数（ＬＶＥＦ）则随之下降。但ＡＡＩ起搏的ＣＯ及ＬＶＥＦ在起搏频率相同情况下显著高于ＶＶＩ起搏组。结论在有心脏病的患者，最佳起搏频率范围较窄，为７０～８０次／分。ＡＡＩ起搏的血流动力学效果显著优于ＶＶＩ起搏。Objective To evaluate the hemodynamic consequences of varying pacing rates in AAI and VVI pacing, in order to find out the optimal pacing rate range and to compare the hemodynamic effects of AAI and VVI pacing.Methods Thirty seven patients with permanent cardiac pacing were divided into 2 groups of AAI ( n =17) and VVI ( n =20) pacing. The pacing rate was programmed from 50 100 beats/min. The pacing hemodynamics were evaluated by echocardiography.Results Cardiac output(CO) increased with increasing pacing rate in both AAI and VVI pacing. In AAI pacing, CO was higher at 70 beats/min than at 50 60 beats/min ( P <0.05). CO remained stable within 80 90 beats/min, but was lower at 100 beats/min than at 90 beats/min. In VVI pacing, CO was higher at 70 beats/min than at 50 beats/min ( P <0.05) and showed no increase when the pacing rate increased over 80 beats/min. At 100 beats/min, both CO and LVEF (left ventrical ejection fraction) were even lower than that at 70 beats/min. CO and LVEF of AAI pacing were significantly higher than VVI pacing at the same pacing rate( P <0.001).Conclusion Patients with heart disease and impaired cardiac function have a narrow range of optimal pacing rates which is 70 80 beats/min. The hemodynamic effect of AAI pacing is superior to that of VVI pacing.

关 键 词：超声心动图 AAI VVI 心脏起搏器 血液动力学 

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