低位房间隔起搏对病窦综合症伴发作性房颤患者的临床应用  

The Clinical Experience of Low Atrial Spetal Pacing in Patients with Sick Sinus Syndrome(SSS) Combined with Paroxysmal Atrial Fibrillation

作　　者：成银宏 秦丰明 唐欧杉 陈钟良 陈丽娜 周浩亮 

机构地区：[1]绍兴二院心内科,浙江绍兴312000

出　　处：《心脑血管病防治》2011年第1期7-9,0-1,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的:探索低位房间隔起搏导线定位方法,评价房间隔起搏对病窦综合征患者房颤的预防作用。方法:病窦综合征患者48例,以X线及心电图特征定位,主动固定心房电极于低位房间隔,观察起搏后P波时限的变化及房颤的发作频率。结果:所有患者经房间隔起搏后,P波时限均显著缩短,118.00±24.00ms比93.00±16.00ms,差异有统计学意义;原有心房内传导延缓者,起搏后阵发性房颤发作频率明显减少,而心房内传导正常者,房颤发作无明显减少。结论:采用主动固定电极导线在低位房间隔起搏是安全、可行的,它能明显缩短左、右心房激动时间,使心房的除极趋于同步化;对伴房间传导阻滞者,房间隔起搏能减少房颤发作。Objective To explore the positioning method of low atrial septal（LAS） pacing with active fixation lead,and evaluate the effectiveness and safety of permanent atrial septal pacing in sick sinus syndrome（SSS） patients with paroxysmal atrial fibrillation.Methods Fourty-eight SSS patients with paroxysmal atrial fibrillation were implanted in LAS with active fixation pacing lead in the suitable atrial position through the assistance of X ray image and ECG.P wave duration and the frequency of atrial fibrillation were observed after LAS pacing.Results All patients were successfully performed atrial septal mapping.The duration of atrial activation with LAS pacing was notably shorter than before [（93±16） ms VS（128±24）ms,P〈0.05].Whereas the frequency of atrial fibrillation was less than before LAS pacing in twenty-nine patients with paroxysmal atrial fibrillation together with interatrial conduction block.Conclusions LAS pacing could markedly shorten biatrial activation time and synchronize atrial depolarization.In patients of paroxysmal atrial fibrillation together with interatrial conduction block,LAS pacing is effective in reducing the frequency of atrial fibrillation.

关 键 词：病窦综合征 低位房间隔 起搏 阵发房颤 

分 类 号：R541.74[医药卫生—心血管疾病]