房室传导正常的病窦综合征患者心房或心室起搏的长期随访  

The Long-Term Follow-up of Patients With Sick Sinus Syndrome and Normal Atrioventricular Conduction After AAI or VVI Pacemaker.

作　　者：赵茹[1] 路雅茹[1] 田青平[1] 吴建国[1] 

机构地区：[1]天津市胸科医院心内科,天津300051

出　　处：《中国心脏起搏与心电生理杂志》2002年第5期352-353,共2页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：评价长期心房或心室起搏对病窦综合征 (SSS)患者心功能及房性心律失常的影响 ,对 1 1 8例SSS伴房室传导正常的患者 (AAI组 56例、VVI组 62例 )进行随访。随访 40 .8± 2 .3个月 ,VVI组 62例中 1 9例NYHA分级增加 ,而AAI组 56例中 4例NYHA分级增加 (P <0 .0 5)。左室射血分数VVI组明显下降 (从 0 .491± 0 .0 4 1至 0 .451± 0 .0 4 3 ,P <0 .0 5) ,而AAI组则增加 (从 0 .482± 0 .0 75增至 0 .535± 0 .0 59,P <0 .0 5)。左房内径VVI组明显增加 (从 33± 6增至 40± 6mm ,P <0 .0 5) ,AAI组从 34± 7增至 36± 6(P >0 .0 5)。房性心律失常发生率VVI组明显增加 (从 35 .5 %增至 45 .2 % ,P <0 .0 5) ,AAI组减少 (从 2 6 .8%降至 0 % ,P <0 .0 1 )。结论 :心房起搏对SSS患者是一安全、可靠的起搏方式 ,可减少房性心律失常的发作 。In patients with sick sinus syndrome(SSS),choice of pacing mode has been i mplicated in the development of congestive heart failure and arrhythmia.A total of 118 patients with SSS and normal atrioventricular conduction were treated wit h either atrial Pacing(AAI group, n =56) or ventricular pacing(VVI group, n =62).Results:At long-term follow-up (mean,40.8±2.3 months) NYHA class was hig her in VVI group than in AAI group.Increase in NYHA class during follow-up was obse rved in 19 of 62 Patients in VVI group versus 4 of 56 in AAI group ( P <0.05). The left ventricular eject function (LVEF) decreased significantly in VVI group (from 0.491±0.041 to 0.451±0.043, P < 0.05 ),The LVEF increased in AAI gro up ( from 0.482±0.075 to 0.535±0.059, P <0.05).The left atrial diameter increased in VVI group (from 33±6 to 40±6 mm, P <0.05).The rate of atrial arrhythmias in VVI group was increased(35.5% to 45.2%, P<0.05) ,whereas the rate of atria l arrhythmias in AAI group was significantly decreased(26.8% to 0%, P<0.01 ).C onclusions:Atrial pacing is p roved to be a safe and reliable treatment for SSS.Physiological pacemakers not o nly improved the long-term cardiac function of patients with SSS,but also red uced atrial arrhythmia.

关 键 词：心血管病学 病窦综合征 生理性心脏起搏 

分 类 号：R541.74[医药卫生—心血管疾病]