不同部位起搏对左房结构与功能的影响  

Influence of cardiac pacing at different sites on left atrial structure and function

作　　者：苏广玉[1] 

机构地区：[1]梅州市人民医院心血管科,广东梅州514000

出　　处：《心血管康复医学杂志》2015年第3期316-318,共3页Chinese Journal of Cardiovascular Rehabilitation Medicine

摘　　要：目的:探讨不同部位起搏对左心房结构和功能的影响。方法:选择我院自2012年01月至2014年01月间因心动过缓需要起搏治疗的62例患者作为研究对象,根据起搏电极放置部位的不同,患者被均分为右室心尖部(RVA)起搏组和右室流出道(RVOT)起搏组,比较两组患者起搏治疗前后左房收缩前容积(LAVp),最小左房容积(LAVmin),最大左房容积(LAVmax),左心房主动排空分数(LAAEF),左心房被动排空分数(LAPEF)等指标的差异。结果:治疗前两组各指标比较无显著差异(P均>0.05);起搏治疗6个月后,与RVA起搏组比较,RVOT起搏组LAVp[(29.5±3.2)ml比(27.1±3.5)ml]、LAVmin[(18.6±2.0)ml比(17.2±2.7)ml]、LAVmax[(48.9±4.8)ml比(46.1±5.1)ml]、LAAEF[(47.2±4.5)%比(43.5±4.2)%]显著减少,LAPEF[(40.9±5.3)%比(43.6±3.9)%]显著提高(P<0.05或<0.01)。结论:右室流出道起搏疗效好于右室心尖部起搏治疗,可作为右室心尖部的起搏部的替代。Objective：To explore the influence of cardiac pacing at different sites on left atrial structure and function . Methods：A total of 62 patients ,who needed cardiac pacing therapy because of bradycardia in our hospital from Jan 2012 to Jan 2014 ,were selected .According to the implanted sites of pacing electrode ,patients were equally divided into right ventricular cardiac apex group （RVA group） and right ventricular outflow tract group （RVOT group） . Left atrial volume before atrial contraction （LAVp） ,minimum left atrial volume （LAVmin） ,maximum left atrial volume （LAVmax） ,left atrial active emptying fraction （LAAEF） and left atrial passive emptying fraction （LA-PEF） etc .were compared between two groups before and after cardiac pacing therapy .Results：There were no sig-nificant difference in all indexes between two groups before treatment ,P〉0.05 all .Compared with RVA group af-ter six-month pacing treatment ,there were significant reductions in LAVp [ （29.5 ± 3.2） ml vs .（27.1 ± 3.5） ml] , LAVmin [ （18.6 ± 2.0） ml vs . （17.2 ± 2.7） ml] ,LAVmax [ （48.9 ± 4.8） ml vs .（46.1 ± 5.1） ml] and LAAEF [（47.2 ± 4.5）% vs .（43.5 ± 4.2）% ] ,and significant rise in LAPEF [（40.9 ± 5.3）% vs .（43.6 ± 3.9）% ] in RVOT group ,P〈0.05 or 〈0.01. Conclusion：Effect of right ventricular outflow tract pacing is more than that of right ventricular cardiac apex pacing and may be used as a replacement of right ventricular cardiac apex .

关 键 词：心脏起搏 人工 心房功能 左 心动过缓 

分 类 号：R541.72[医药卫生—心血管疾病]