右室流出道室间隔起搏的临床观察  

Clinical observation of ventricular septal pacing in right ventricular outflow tract

作　　者：冯胜红 王生平[1] 冯永生[1] 任静[1] 

机构地区：[1]达州市中西医结合医院心血管内科,四川达州635000

出　　处：《中西医结合心血管病电子杂志》2015年第6期96-98,共3页Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine

摘　　要：目的研究探讨右室流出道（RVOT）室间隔与右室心尖部（RVA）起搏方式差异,分析RVOT室间隔起搏的应用价值。方法回顾性分析本院2012年7月～2014年7月收治的缓慢心律失常患者89例的临床资料,按照起搏器植入方式不同分为观察组与对照组,其中观察组45例,采用主动螺旋固定电极行RVOT室间隔起搏,对照组44例,采用被动翼状固定电极经RVA起搏,对两组患者植入起搏器前后心室电活动、R波宽窄以及心功能情况等。结果全部患者均成功植入,观察组患者QRS波时限比较中,术后4周及半年后均明显窄于对照组,差异有统计学意义（t=5.2600,P〈0.05）;两组患者左室舒张末径（LVEDD）、左室射血分数（LVEF）等心功能指标在术后不同时间段比较,差异无统计学意义（P〉0.05）;对照组患者在植入手术时与术后半年相比较,LVEDD、LVEF指标差异均有统计学意义（t=3.3949,P〈0.05）。结论使用主动螺旋固定电极行RVOT室间隔起搏符合生理性起搏方式,对患者正常心脏构造无过度影响,安全可靠。Objective To investigate right ventricular outflow Road（RVOT）interventricular septum and right ventricular apex Department（RVA）pacing differences,analysis of the right ventricular outflow tract septal pacing application value.Methods A retrospective analysis of our hospital in 2012 July 2014 in July from 89 cases of slow arrhythmia in patients with clinical data,in accordance with the pacemaker implantation were divided into observation group and control group,the observation group（45 cases）,using active screw fixed electrode RVOT ventricular septal pacing and 44 cases in the control group,using fixed tined electrode by RVA pacing,before and after the two groups of patients implanted pacemaker ventricular electrical activity,R wave width and heart function situation.Results All patients were successfully implanted in observed group of patients with QRS wave duration,postoperative 4 weeks and 6 months later were significantly narrower than that of the control group（t=5.2600,P〈0.05）difference has statistical significance;two groups of patients with left ventricular end diastolic diameter（LVEDd）,left ventricular shoot ejection fraction（LVEF）and other indexes of cardiac function in different time points after surgery had no significant difference, is not statistically significant,the control group patients in implant surgery and postoperative half a year,LVEDd,LVEF indexes were different（P〈0.05,t=3.3949）have statistical significance.Conclusion The use of active screw fixed electrode in right ventricular outflow tract septal pacing physiological pacing mode,in patients with normal cardiac structure without excessive effects, safe and reliable.

关 键 词：RVOT 室间隔 主动电极 心功能 

分 类 号：R54[医药卫生—心血管疾病]