实时三维超声心动图对右心室间隔起搏导线定位的评价  

Right ventricular septal pacing lead site：a real-time three-dimensional echocardiography study

作　　者：高春恒[1] 邹大中[1] 易桂斌[1] 张华[1] 

机构地区：[1]江苏省江阴市人民医院心超室,214400

出　　处：《中华心律失常学杂志》2015年第1期41-44,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的：初步评价实时三维超声心动图（ RT3DE）定位右心室间隔起搏部位的可行性。方法选取2010年12月至2013年12月年在江阴市人民医院心内科的50例植入右心室间隔部主动固定起搏导线患者作为研究对象，男26例，年龄42∽70（62±8）岁。 RT3DE将右心室起搏位置分为心尖、游离壁、高位右心室间隔部、中低位右心室间隔部。以二维经胸超声心动图（2D-TTE）定位起搏器导线位置为标准，分析RT3DE与2D-TTE对右心室间隔起搏导线定位的一致性。结果 RT3DE与2D-TTE在区别右心室心尖部、右心室间隔部、右心室游离壁起搏导线头端解剖位置达到高度一致性（ K=1．0）。2D-TTE无法精确定位右心室间隔部起搏导线位置，而RT3DE可以显示右心室间隔部起搏导线头端位置位于高位还是中、低位。结论 RT3DE技术可以定位右心室起搏导线位置，特别在定位右心室间隔起搏部位位于高位还是中低位时较2D-TTE更具优势。Objective To evaluate feasibility of real-time three-dimensional echocardiography （RT3DE） in locating right ventricular septal pacing site. Methods Fifty patients installed permanent active fixation electrode in right ventricular septum were selected. All patients were inpatient in the department of car-diology in Jiangyin People’s hospital from December 2010 to December 2013. Right ventricular pacing position included the apical,free wall,high position of right ventricular septum,low position of right ventricular septum. Two-dimensional transthoracic echocardiography（2D-TTE） was regarded as the standard for locating pacemaker electrode site,the Kappa coefficient was used to evaluate consistency between RT3DE and 2D-TTE. Results Difference of RT3DE and 2D-TTE in pacemaker electrode tip anatomical position among right ventricular apex, right ventricular septum,right ventricular free wall achieved a high degree of consistency （K=1. 0）,but 2D-TTE was unable to accurately display the detail position of pacemaker electrode in right ventricular septum. RT3DE can recognize the pacemaker electrode in the high,middle or low position of right ventricular septum. Conclusion RT3DE can locate the pacing lead position in right ventricular,even superior to 2D-TTE especial-ly in the high,middle or low position of right ventricular septum.

关 键 词：超声心动图 三维 起搏 定位 

分 类 号：R540.45[医药卫生—心血管疾病]