右室流出道间隔部和心尖部起搏对心功能和重构的影响  

Effects of right ventricular outflow tract and right ventricular apical pacing on cardiac function and remodeling

作　　者：李萍[1] 石泉[1] 程晓曙[1] 胡建新[1] 吴清华[1] 吴延庆[1] 刘燕娜[1] 苏海[1] 

机构地区：[1]南昌大学第二附属医院南昌大学心血管病研究所,江西南昌330006

出　　处：《中国心脏起搏与心电生理杂志》2011年第1期31-33,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的比较右室流出道(RVOT)和右室心尖部(RVA)起搏对心脏做功和重构的影响。方法 83例缓慢心律失常的患者,其中男40例,女43例,随机分为RVOT间隔部起搏组(RVOT组,n=42)和RVA部起搏组(RVA组,n=41),观察两组QRS波时限、新出现心房颤动(简称房颤)的情况、心腔内径及左室射血分数(LVEF)的变化。结果随访11.47±1.67个月,两组术后QRS波时限均较术前明显延长(P<0.01),RVA组明显长于RVOT组(P<0.01);两组的左房内径和左室收缩末径均未见明显变化,RVA组1年后左室舒张末径较术前显著增加(53.53±5.72 mm vs 50.03±6.20 mm,P<0.05),两组1年后LVEF均较术前显著降低(RVOT、RVA比较分别为0.57±0.10 vs 0.62±0.11,0.53±0.08 vs 0.63±0.10,P均<0.01);两组新出现房颤例数亦未见差异。结论 RVOT起搏对心室重构的影响要好于RVA起搏。Objective To compare the potential effect of right ventricular outflow tract（RVOT） pacing and right ventricular apical （ RVA ） pacing on cardiac function and ventricular remodeling. Methods Eighty-three bradyarrhythmia pa- tients were enrolled to this study which included 40 males and 43 females who was randomly divided into RVOT pacing group（ n = 42 ） or RVA pacing group （n =43 ）. The change of QRS duration, new onset of atrial fibrillation, cardiac internal diameter and left ventricular ejection fraction （LVEF） were observed in two groups. Results Mean follow-up time was 11.47 ± 1.67 months. Post-operation QRS duration was significantly prolonged in both two groups with it much longer in RVA group than that in RVOT group（ P 〈 0.01 ）. There were no significant difference of left atrial dimension and left ventricular end- systolic diameter in both groups ,while left ventricular end-diastolic diameter significantly increased at one year post-implantation in RVA group（53.53 ± 5.72 mm vs 50.03 ± 6.20 mm, P 〈 0. 05 ）and LVEF statistically decreased in both groups （ all P 〈 0.01 ）. There was no significant difference of new onset atrial fibrillation in both groups. Conclusions The influence of RVOT pacing on ventricular remodeling is better than that of RVA pacing.

关 键 词：心血管病学 右室流出道起搏 心功能 重构 心房颤动 

分 类 号：R318.11[医药卫生—生物医学工程]