心室自身优先功能对右室起搏比率及心功能的影响  

Influence of ventricular intrinsic preference algorithm on the percentage of right ventricular pacing and heart function

作　　者：蔡振荣[1,2] 王志华[1,2] 庄晓华[1,2] 凌佳[1,2] 阚丽虹[1,2] 汪飞[1,2] 陈惠君[1,2] 李晓鸣[1,2] 陆铭[1,2] 罗心平[3] 

机构地区：[1]上海市浦东医院 [2]复旦大学附属浦东医院心血管内科,上海201399 [3]复旦大学附属华山医院心血管内科,上海200040

出　　处：《中国心脏起搏与心电生理杂志》2014年第1期21-23,共3页Chinese Journal of Cardiac Pacing and Electrophysiology

基　　金：浦东新区卫生系统学科带头培养计划(编号:PWRd 2013-06)

摘　　要：目的观察具有心室自身优先功能(VIP)的起搏器对右室起搏比率及心脏功能的影响。方法入选因缓慢性心律失常安装心脏起搏器的患者。所有患者均放置心房电极于右心耳,心室电极于右室心尖部;根据植入后是否开启心室自身优先功能分为实验组及对照组,分别在置入前及置入后12个月进行随访,观察两组右室起搏比例,左房内径(LAD),左室射血分数(LVEF),左室舒张末内径(LVEDD),血浆脑钠肽(BNP)水平及6 min步行试验距离。结果 62例患者入选,实验组30例,对照组32例,术后12个月,与对照组相比,实验组心室起搏比例明显降低[(21.43%±8.57%)vs(55.26%±12.36%),P<0.001]。与实验组比较,对照组LAD、LVEDD显著增大,LVEF降低,6 min步行实验距离更短(P<0.05);术后1年,对照组BNP水平显著高于实验组(P<0.05)。结论 VIP功能可以明显减少右室起搏比例,并保护心功能。Objective To investigate the impacts of ventricular intrinsic preference （VIP） algorithm on percentage of right ventricular pacing and heart function. Method Patients received permanent cardiac pacemaker for bradyarrhyth- mias were enrolled. Atrial leads were placed at right atricular appendage, ventricular leads were placed at right ventricuIar apex. The subjects were divided into experimental group and control group according to the functiong of VIP switched on or off. the concentration of brain natriuretic peptide （BNP）. Left atrial diameter （LAD）, left ventricular ejection fracetion （LVEF） ,left ventricular end diastolic diameter（LVEDD） were measured before operation and 12 months after implanting. The percentage of right ventricuIar pacing , the echocardiography parameters, the concentration of BNP and the distance of 6-minutes walking test at implantation and after implantation were compared respectively. Result A total of 62 patients were divided into experimental group （ n = 30） and control group （ n = 32 ） ： At 12 months after operation, the percentage of right ventricular pacing in experimental group decreased signifcantly compared with the control group[ （21.43% ±8.57% ） vs （55.26% ±12.36% ）, P〈0. 001 ], LAD and LVEDD in control group were significantly larger, LVEF and the distance of 6-minutes walking test in control group were significantly lower（ P〈0.05 ）, the concentration of BNP in control group was higher than that in experimental group（P〈0.05）. Conclusion VIP algorithm can effectively reduce the percentage of ventricular pacing, and protect heart function.

关 键 词：心血管病学 心脏起搏 心室自身优先 心功能 

分 类 号：R318.11[医药卫生—生物医学工程] R331.31[医药卫生—基础医学]