右心室心尖部与间隔部起搏对室壁同步性的影响  

Influence of the synchronism of the movement of myocardium by the selection of right ventricular apex pacing and right ventricular septum pacing

作　　者：贺军[1] 苟志平[1] 秦川[2] 张艳红[3] 

机构地区：[1]新疆克拉玛依市中心医院心血管内科,新疆克拉玛依834000 [2]新疆克拉玛依市中心医院功能科 [3]新疆克拉玛依市中心医院药剂科

出　　处：《临床心血管病杂志》2010年第12期935-938,共4页Journal of Clinical Cardiology

摘　　要：目的:采用定量组织速度成像(QTVI)技术,评价右心室心尖部(RVA)及间隔部(RVS)起搏对室壁运动的影响。方法:选择56例RVA起搏(RVA)组患者,静息状态下同步记录磁频心电图,在QTVI模式下采集标准心尖四腔、心尖二腔和左室长轴的彩色组织多普勒图像并储存,测量左、右心室各室壁基底段、中间段心肌收缩时间间期,评价RVA与RVS起搏时心肌运动的变化。结果:①与RVS组比较,RVA组部分心肌收缩达峰时间明显延迟,以左室侧壁、后壁为著;②与RVS组比较,RVA组QRS波增宽,左心室内机械收缩同步性及左、右心室间机械收缩同步性降低。结论:与RVA起搏比较,RVS起搏有利于保持心肌电活动和机械收缩的同步性。Objective：To evaluate the influence of the movement of myocardium by the selection of right ventricular apex pacing （RVA） and right ventricular septum pacing（RVS） with the quantitative tissue velocity imaging （QTVI）.Method：The 56 patients with cardiac pacing were divided into RVA group and RVS group.To record two groups of patients＇ the simultaneous ECG with magnetic-frequency in quiescent condition,collect their the Doppler imaging of apical four chamber view,apical two chamber view and the left ventricular axis view in the TVI mode,measure the systole time of basal and middle parts of different walls,and evaluate the movement of myocardium by RVA and RVS pacing.Result：①Compared with RVS group,the systole peak time in some myocardial segments delayed obviously in RVA group,especially in the left ventricle lateral wall and posterior wall.②Compared with RVS group,the QRS duration was wider in RVA group; and the mechanical systolic synchronism,in the left ventricle and the biventricular,was reduced in RVA group.Conclusion：RVS pacing has more advantages to keep the myocardial electro-synchronism and the mechanical systolic synchronism,than that of RVA group.

关 键 词：心律失常 起搏部位 心肌运动 同步性 定量组织速度成像 

分 类 号：R541.7[医药卫生—心血管疾病]