右心室流出道间隔部单腔起搏对慢性心房颤动伴长RR间期患者左心室的影响  

Influence of right ventricular outflow tract septum single pacing on left ventricle in patients with chronic atrial fibrillation and long RR interval

作　　者：吴兴安 李秀琪 谢刚 余稳 韩静 谭安娜 

机构地区：[1]长江航运总医院&武汉脑科医院心内科,武汉430010 [2]长江航运总医院&武汉脑科医院超声科,武汉430010

出　　处：《岭南心血管病杂志》2016年第2期158-160,共3页South China Journal of Cardiovascular Diseases

摘　　要：目的研究不同右心室单腔起搏部位及不同起搏比例对慢性心房颤动(房颤)伴长RR间期患者左心室结构及心功能的影响。方法选择48例慢性房颤伴长RR间期并植入永久性右心室单腔起搏器患者,根据右心室起搏部位分为室间隔起搏组和心尖部起搏组,随访并对其手术前后临床特征、心电图、超声心动图(ultrasonic cardiogram,UCG)、血浆脑钠肽(brain natriuretic peptide,BNP)浓度及术后起搏比例进行统计分析。结果右心室间隔部起搏组左心室舒张末内径(left ventricular end-diastolic diameter,LVEDD)、血浆BNP浓度均低于心尖部起搏组,差异有统计学意义(P<0.05);左心室射血分数(left ventricular ejection fraction,LVEF)则高于心尖部起搏组,差异有统计学意义(P<0.05)。结论右心室流出道间隔部单腔起搏且起搏比例低对慢性房颤伴长RR间期患者左心室结构及心功能的影响较小。Objectives To investigate the influence of different pacing site and pacing ratio of right ventricular outflow tract septum pacing on left ventricle in patients with chronic atrial fibrillation and long RR interval. Methods Forty- eight patients with chronic atrial fibrillation and long RR interval who underwent implantation of single chamber permanent pacemaker were selected. They were divided into right ventricular outflow tract septum （RVOT） group and right ventricular apical （RVA） group according to different pacing sites. Clinical characteristics, electrocardiogram （ECG）, ultrasonic cardiogram （UCG）, plasma concentration of brain natriuretic peptide （BNP） and pacing ratio after operation were checked and compared between the two groups. Results Compared with RVA group,left ventricular end-diastolic diameter （LVEDD） and plasma concentration of BNP significantly decreased in RVOT group （P〈0.05）; and left ventricular ejection fraction （LVEF） significantly increased （P〈0.05）. Conclusions In chronic atrial fibrillation patients with coexisting long RR interval, the left ventricular function can be better protected by RVOT pacing than RVA pacing.

关 键 词：心房颤动 心脏起搏器 右心室间隔部 左心室射血分数 

分 类 号：R541.7[医药卫生—心血管疾病]