左室多部位起搏对心脏电激动同步性及复极参数影响的初步临床研究  

A Primary Clinical Study of the Effects of Multisite Left Ventricular Pacing on Cardiac Electrical Synchrony and Repolarization Parameters

作　　者：陈慧[1] 蓝荣芳[1] 林若薇[1] 刘威[1] 徐伟[1] 

机构地区：[1]南京大学医学院附属鼓楼医院,江苏南京210008

出　　处：《现代生物医学进展》2016年第8期1475-1478,1505,共5页Progress in Modern Biomedicine

摘　　要：目的:探讨与传统心脏再同步化治疗(Bi-Ventricular Pacing Cardiac Resynchronization Therapy,Bi-V CRT)相比,左室多部位起搏(Multisite Left Ventricular Pacing,MSLV)CRT对术后起搏心电图QRS波时限及心肌复极参数的影响。方法:选取具有最新指南推荐植入心脏再同步化起搏或/和除颤器(CRT-P/CRT-D)适应症的患者。术中设定左室单部位与右室(1LV+RV)起搏和左室双部位与右室(2LV+RV)起搏。同时采集即时体表12导联心电图。分析比较2种起搏模式下患者的术后起搏心电图QRS波时限、QTc间期、JTc间期及Tp-e间期。结果:(1)共采集了21份左室单部位与右室起搏心电图,18份左室双部位与右室起搏心电图;(2)与1LV+RV相比,2LV+RV可进一步缩短术后QRS时限(△QRS:-5.57±12.52 ms vs-14.94±14.01 ms,P=0.034);(3)1LV+RV与2LV+RV比较,QTc、JTc及Tp-e时限无差异(P>0.05)。结论:与Bi-V CRT相比,MSLV CRT可进一步缩短QRS时限,但不能缩短心肌复极时间。To investigate the effects of multi-site left ventricular pacing（MSLV） cardiac resynchronization therapy（CRT）on pacing electrocardiogram QRS duration and myocardial repolarization parameters compared with traditional biventricular pacing cardiac resynchronization therapy（Bi-V CRT）. Methods： Patients who meet the newest guidelines of cardiac resynchronization therapy and/or defibrillator（CRT-P/CRT-D） implantation were enrolled. During operation,we set one-site left ventricular plus right ventricular（1LV ＋ RV） pacing, two-site left ventricular plus right ventricular（2 LV ＋ RV） pacing. Surface 12-lead electrocardiograms are collected and electrocardiogram QRS duration and myocardial repolarization parameters of two pacing modes are analyzed. Results：（1）We have collected 21 electrocardiograms of 1LV ＋ RV and 18 electrocardiograms of 2LV ＋ RV.（2） Compared with the 1LV ＋ RV, 2 LV＋ RV can further decrease QRS duration（△QRS：-5.57±12.52 ms vs-14.94 ±14.01 ms, P=0.034）.（3） QTc, JTc and Tp-ec duration of2 LV ＋ RV is same to 1LV ＋ RV（P〈0.05）. Conclusion： Compared with the Bi-V CRT, MSLV CRT can further decrease QRS duration,but cannot reduce myocardial repolarization time.

关 键 词：心脏再同步化治疗 左室多部位起搏 QRS时限 心肌复极参数 

分 类 号：R541.76[医药卫生—心血管疾病]