起搏器抗心动过速起搏干预心房高频事件的疗效分析  

The effect of pacemaker reactive anti-tachycardia pacing on atrial high-frequency events

作　　者：李倩[1] 侯锦婷 于波[1] LI Qian;HOU Jing-ting;YU Bo(First Affilliated Hospital of China Medical University,Shenyang 110001,Liaoning,China)

机构地区：[1]中国医科大学附属第一医院,辽宁沈阳110001

出　　处：《中国心脏起搏与心电生理杂志》2021年第3期214-219,共6页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的评价抗心动过速起搏(rATP)干预心房高频事件的有效性。方法研究对象为符合起搏器植入指征、置入DDDRP起搏器(Medtronic,A3DR01)同时合并心房颤动(AF)的患者49例,依据其起搏器植入指征分为病窦综合征(SSS)组和房室传导阻滞(AVB)组两组,rATP功能在置入术后1个月随访时打开,记录房性心动过速(AT)/AF负荷基线值,3个月后再次随访记录AT/AF负荷,比较在rATP功能开启前后患者AF/AT负荷的差异;rATP降低AT/AF负荷的患者有效率;rATP终止AT/AF事件的有效率以及影响rATP干预效果的相关因素。结果 49例患者分为SSS组(34例)和AVB组(15例)两组,在3个月的随访期内均无起搏器相关并发症,于起搏器植入术后1个月程控随访时记录AT/AF负荷基线7.1%(1.6%,15.7%),并打开rATP功能,3个月后再次随访程控记录房颤负荷为6.2%(1.0%,15.1%),rATP功能打开后AT/AF负荷较打开前减小(P值0.003)。AT/AF负荷改善32例(65.3%),其中SSS组23例(67.7%)与AVB组9例(60.0%),两组之间患者有效率无差异。rATP治疗的总阵数约5 088阵,其中有效终止AT/AF事件的rATP阵数约3 076阵,rATP干预的有效性约60.5%。rATP的干预效果与AT/AF事件发生时心房频率的规整性相关[规整78.6%(22/28) vs不规整47.6%(10/21)]。结论 rATP可有效降低AT/AF负荷;rATP的干预效果与AT/AF事件发生时心房频率的规整性密切相关。Objective To evaluate the effectiveness of reactive anti-tachycardia pacing(rATP) intervention in atrial fibrillation(AF). Methods The study subjects were 49 patients who have the pacemaker implantation indications and implanted DDDRP pacemaker(Medtronic, A3 DR01) and with concurrent AF.According to the pacemaker implantation indications, they were divided into sick sinus node syndrome(SSS) group and the atrioventricular block(AVB) group, rATP function was turned on at the first month of follow-up period after implantation and recorded the atrial tachycardia/AF(AT/AF) burden baseline, and recorded it again after 3 months follow-up.Then we observed the changes of AT/AF burden, made a contrast about it between before and after intervention, evaluated the efficiency of patients with reduced AT/AF load by rATP,compared the differences between the groups, at the same time, assessed the effectiveness of rATP to terminate AT/AF events and the relation factors affecting the effect of rATP. Results Forty-nine patients were divided into SSS group(34 cases) and AVB group(15 cases),There were no pacemaker-related complications during the 3-month follow-up period. At the first month of follow-up, the AT/AF baseline load was7.1%(1.6%,15.7%), and then turning on the rATP function, after 3 months it was 6.2%(1.0%,15.1%),The change have the statistically significant(P value 0.003).The AT/AF load improved in 32 patients(65.3%),including 23 patients(67.7%) of the SSS group and 9 patients(60.0%) of the AVB group, There was no statistically significant difference in patient response between the two groups.The total number of rATP treatments was about 5 088,of which the number of rATP effectively terminate AT/AF events was approximate 3 076,and the effectiveness of rATP intervention was about 60.5%.The effect of rATP intervention was related to the regularity of the atrial rhythm at the time of the AT/AF event[78.6%(22/28)vs 47.6%(10/21)].Conclusion rATP can effectively reduce the AT/AF burden;the effective of rATP is associated with

关 键 词：心血管病学 人工心脏起搏 抗心动过速起搏 心房颤动 

分 类 号：R541.7+5[医药卫生—心血管疾病] R318.11[医药卫生—内科学]