间隔部主动固定电极对老年患者心功能的影响  

Impact of right ventricular septal active fixation lead on cardiac functions in elderly patients

作　　者：傅春江[1] 石伟彬[1] 舒娴[1] 罗晓丽[1] 陈乔[1] 杨立[1] 王旭开[1] 

机构地区：[1]第三军医大学大坪医院野战外科研究所心内科,重庆市心血管病研究所重庆400042

出　　处：《中华老年多器官疾病杂志》2013年第3期197-200,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的探讨右室间隔部（RVS）主动固定电极对植入永久起搏器的老年患者心功能的影响。方法入选78例植入永久起搏器的老年患者，分为RVS起搏组（实验组，植入主动固定电极，n=42）和右室心尖部（RVA）起搏组（对照组，植入被动固定电极，n=36），以超声心动图评价两组术前、术后6个月左室缩短率（FS）、每搏输出量（SV）、心输出量（CO）、左室射血分数（LVEF）、E／AI：L值的差异。结果术前两组心功能状况无明显差异（P〉0．05）。术后6个月，RVS起博组与术前相比较，FS、SV、CO、EF、E／A虽有下降趋势，但差异无统计学意义（P〉0．05）；RVA起博组在术后6个月FS与对照组差异无统计学意义（P〉0．05），但SV、CO、EF、E／A均高于RVS起博组（P〈0．05）。两组起搏阈值、感知、阻抗起搏比例及平均心率等差异均无统计学意义（P〉0．05）。结论RVS起搏对患者心功能的影响优于右室心尖部起搏。Objective To investigate the impact of right ventricular septal （RVS） active fixation lead on cardiac functions in elderly patients implanted with permanent pacemakers. Methods A total of 78 patients at an average age of 71.9 ＋ 6.7 implanted with permanent pacemakers in our hospital during June 2008 to May 2011 were enrolled into this study. They were divided into 2 groups according to their own will of which type of pacemaker, that is, RVS pacing group （experiment group, implanted with active fixation lead, n = 42） and right ventricular apical （RVA） pacing group （control group, implanted with passive fixation lead, n = 36）. Their fractional shortening （FS）, stroke volume （SV）, cardiac outcome （CO）, left ventricular ejection fraction （LVEF） and E/A ratio （early to late atrial ventricular filling velocity） were evaluated by echocardiography before and 6 months after implantation. Results No significant difference in cardiac functions was found between the 2 groups before implantation （P 〉 0.05）. A trend of decrease was found in FS, SV, CO, LVEF, and E/A ratio in RVS pacing group in 6 months after implantation though without significant difference （P 〉 0.05）. Despite that RVA pacing group had no difference in FS compared with RVS pacing group in 6 months after implantation, it had significantly higher SV, CO, LVEF, and E/A ratio （P 〈 0.05）. There was no difference in pacing threshold, perception, impedance pacing rate, and mean heart rate between the 2 groups （P 〉 0.05）. Conclusion RVS pacemaker implantation is superior to RVA pacemaker implantation in cardiac functions for senile patients.

关 键 词：右室间隔部 右室心尖部 心功能 

分 类 号：R541.7[医药卫生—心血管疾病]