左室起搏对完全性左束支阻滞QRS波时限的影响  

Effect of single left ventricular(LV) pacing on ECG QRS duration in patients with complete left bundle branch block

作　　者：郎勇[1] 吴立荣[1] 田芸[2] 郭继鸿[2] 

机构地区：[1]贵阳医学院附属医院心内科,贵州贵阳550004 [2]北京大学人民医院心脏中心,北京100044

出　　处：《贵州医药》2013年第3期198-200,共3页Guizhou Medical Journal

摘　　要：目的了解左室起搏对完全性左束支阻滞心电图QRS波时限的影响。方法选择扩心病合并完全性左束支阻滞并植入心脏再同步化治疗(CRT)的患者10例(男8例,女2例),分别记录窦性心律、AV=PR单纯左室起搏、AV=PR-30ms左室起搏及双室起搏时的12导联体表心电图,对QRS波时限进行对比分析。结果QRS波时限窦性心律为(171.50±21.59)ms,AV=PR左室起搏为(141.00±17.36)ms,AV=PR-30ms左室起搏为(144.20±14.37)ms,双室起搏为(157.40±25.19)ms,分别较窦性心律缩短(31.50±17.55)ms、(27.30±13.95)ms、(16.10±7.64)ms。左室起搏AV=PR与AV=PR-30ms两组间差异无统计学意义(P=0.242),左室起搏AV=PR与双室起搏、左室起搏AV=PR-30ms与双室起搏差异均有统计学意义(P值分别为0.015和0.017)。结论左室起搏较双室起搏能更有效地缩短体表心电图QRS波时限;但继续缩短左室起搏间期未能进一步减少QRS波时限。Objective To detect the effect of single left ventricular （LV） pacing on ECG QRS duration in patients with complete left bundle branch block （CLBBB）. Methods 8 male and 2 female pa- tients with dilated cardiomyopathy （DCM） and CLBBB, who have been treated by CRT, were en- rolled. Measuring the QRS durations of sinus rhythm, single LV pacing of AV= PR, single LV pacing of AV= PR-30ms and biventricular pacing, followed by the comparative analysis. Results The data of QRS duration as follow： sinus rhythm （ 171. 50 ± 21. 59） ms, single LV pacing （ AV = PR） （141.00±17.36） ms,single LV pacing （AV=PR-30ms） （144.20±14.37）ms, biventricular （157.40±25.19）ms, which were reduced respectively in （31.50±17.55） ms, （27.30±13.96） ms, （16.10± 7.64） ms comparing to sinus rhythm. There is no statistical difference between Single LV pacing of AV= PR and that of AV = PR-30ms （P = 0. 242）. However, single LV pacing of AV = PR and biventricular pacing, single LV pacing of AV= PR-30ms and biventricular pacing both have statistical difference respectively （P= 0. 015, 0. 017）. Conclusion Comparing to biventricular pacing,single LV pacing is more effective in reducing the QRS duration. Reducing LV pacing interval furthermore, however, the QRS duration could not changed correspondingly.

关 键 词：完全性左束支传导阻滞 单纯左室起搏 QRS波时限 心脏再同步化治疗 

分 类 号：R541.76[医药卫生—心血管疾病]