选择性部位起搏对左室收缩同步性的影响  

Right ventricular apical versus right ventricular outflow tract pacing: impact on left ventricular synchronization

作　　者：陈东骊[1] 汤娇娇[1] 陈泗林[1] 林纯莹[1] 刘烈[1] 张黔桓[1] 梁远红[1] 彭湖[1] 陈燕[1] 魏会强[1] 

机构地区：[1]广东省人民医院//广东省医学科学院//广东省心血管病研究所,广东广州510080

出　　处：《南方医科大学学报》2014年第10期1551-1554,共4页Journal of Southern Medical University

基　　金：K-13减拨科学事业经费专项资金研究(2011B061300072)

摘　　要：目的应用二维斑点追踪成像超声技术,通过计算起搏后左室各节段收缩时间的差异,比较右室心尖(RVA)起搏与右室流出道(RVOT)间隔起搏时对左室收缩同步性的影响。方法入选符合起搏器植入适应证的患者60例,随机分为RVA组30例,RVOT组30例。RVA组患者右室电极植于右室心尖部,RVOT组患者右室电极植于右室流出道间隔部。所有患者术后程控心室电极100%起搏,应用二维斑点追踪成像技术,测量左室径向应变达峰时间的差异。结果 RVA组起搏后,左室6节段径向应变达峰时间的最大差、标准差分别为105.27±19.74 ms、42.71±17.63 ms;RVOT组起搏后6节段径向应变达峰时间的最大差、标准差分别为41.65±12.17 ms、17.63±5.62 ms,两组比较各指标均有差异(P<0.01)。结论 RVOT间隔部起搏后的左室收缩同步性优于RVA起搏。Objective To compare the impact of right ventricular apical （RVA） versus right ventricular outflow tract （RVOT） pacing on left ventricular systolic synchronization. Methods Sixty patients were prospectively recruited and randomized into RVA group （n=30） with the right ventricle leads placed in the RVA and RVOT group （n=30） with right ventricle leads placed in the septum of the RVOT. Speckle tracking imaging was performed with 100% ventricle pacing to measure the differences in the time to maximum left ventricle （LV） radial strain. Results In RVA group, the difference in the time to 6-segment maximum LV radial strain after pacing was 105.27＋19.74 ms, significantly greater than that in RVOT group （41.65＋12.17 ms, P〈0.001）. The standard difference of time to 6-segment maximum LV radial strain was also significantly greater in RVA group than in RVOT group （42.71 ± 17.63 vs 17.63 ± 5.62 ms, P〈0.001）. Conclusion Left ventricle systolic synchronizaition after RVOT pacing is superior to RVA pacing.

关 键 词：右室流出道 选择性部位起搏 斑点追踪技术 超声心动图 同步性 

分 类 号：R541.7[医药卫生—心血管疾病]