VVI模式下右室不同部位起搏对左室收缩同步性及心功能的影响观察  

The effect of VVI pacing in different sites of the right ventricle on left ventricular systolic synchronicity and cardiac function

作　　者：崔俊友[1] 张华[1] 高春恒[1] 殷泉忠[1] 易桂斌[1] 陆叶[1] 李健[1] 王东升[1] 

机构地区：[1]江阴市人民医院心脏科,江苏江阴214400

出　　处：《南京医科大学学报（自然科学版）》2011年第6期847-850,共4页Journal of Nanjing Medical University(Natural Sciences)

基　　金：2008年无锡市科技局社会发展项目(CSZ00805)

摘　　要：目的:评价VVI模式下右室间隔部起搏和右室心尖部起搏1年后对左室收缩同步性的影响。方法:选择60例只能接受VVI单腔起搏治疗且起搏依赖的患者,分为右室间隔部起搏组(RVSP组,n=30例),和右室心尖部起搏组(RVAP组,n=30例)。于术前及术后1年测定左室射血分数(LVEF),同时应用实时三维超声心动图技术获取实时三维超声心动图时间-容积曲线,评价左室收缩同步性。结果:术前两组左室收缩的同步性及LVEF无显著差异;随访1年后,RVSP组与RVAP组相比,LVEF稍有提高,但无统计学差异(P>0.05),左室收缩同步性指标Tmsv 16-SD%、Tmsv 12-SD%明显下降,差异有统计学意义(P<0.05)。结论:RVSP较RVAP左室收缩的同步性好,左室收缩功能影响小,更接近于生理起搏。Objective：To investigate the effects of right ventricular apex pacing（RVAP）or right ventricular outflow tract septal pacing（RVSP）on left ventricular systolic synchronicity and cardiac function in VVI mode after 1-year of implantation.Methods：Sixty patients who were dependent on pacemaker and can only received VVI single-chamber pacemaker implantation were devided in-to two groups：the right ventricular apex pacing group（RVAP group,n=30）and the right ventricular outflow tract septal pacing group（RVSP group,n=30）.The left ventricular ejection fraction（LVEF）was measured before and one year after operation.The time-vol-ume curves were also recorded by real time three dimensional echocardiography（RT-3DE）to evaluate left ventricular systolic syn-chronicity.Results：There were no differences on left ventricular systolic synchronicity and LVEF between the two groups before op-eration.After one year’ follow-up,LVEF in RVSP group increased,but no difference compared with that in RVAP group（P 〉 0.05）.However,the parameters of left ventricular systolic synchronieity（Tmsv 16-SD%and Tmsv 12-SD%）significantly decreased in RVSP group（P 〈 0.05）.Conclusion：The RVSP pacemaker keeps better left ventricular synchronous contraction and has less negative ef-fects on the cardiac function than RVAP pacemaker.Therefore RVSP pacemaker is in accordance with physiological pacing.

关 键 词：右室起搏 左室同步性 实时三维超声心动图 

分 类 号：R541.7[医药卫生—心血管疾病]