右室间隔部起搏器植入对房室传导阻滞患者QRS波群时限及心功能的影响  

Effects of right septal pacemaker implantation on QRS duration and cardiac function in patients with atrioventricular block

作　　者：崔姣姣 张申伟 CUI Jiaojiao;ZHANG Shenwei(Department of Cardiology,the Seventh People’s Hospital of Zhengzhou,Zhengzhou 450000,China)

机构地区：[1]郑州市第七人民医院心内科,郑州450000

出　　处：《上海医药》2022年第23期37-40,共4页Shanghai Medical & Pharmaceutical Journal

摘　　要：目的:探讨右室间隔部起搏器植入在房室传导阻滞(AVB)患者中的应用效果及对心功能的影响。方法:将82例AVB患者随机分为对照组和观察组,各41例。对照组采用右室心尖部植入起搏器治疗,观察组采用右室间隔部植入起搏器治疗,均随访6个月。比较两组QRS波群时限、心功能指标、心率变化、血流动力学变化、起搏器参数、生活质量及不良心血管事件。结果:治疗后,观察组QRS波群时限短于对照组,左室射血分数、心率、每搏量、心脏指数、左室舒张早期最大充盈速度/左室舒张晚期最大充盈速度、R波振幅、生活质量各领域评分等高于对照组;左室舒张末、收缩末内径、电压阈值、不良心血管事件发生率等低于对照组(P<0.05)。结论:右室间隔部植入起搏器治疗AVB效果更佳,能够保护心功能,减轻对心脏血流动力学的影响,降低不良心血管事件风险,改善患者生活质量。Objective:To explore the effects of right ventricular septal pacemaker implantation in patients with atrioventricular block(AVB)and its influence on cardiac function.Methods:Eighty-two patients with AVB were randomly divided into a control group and an observation group with 41 cases each.The control group was treated with a right ventricular apical implantable pacemaker while the observation group was treated with a right ventricular septal implantable pacemaker,and both were followed up for 6 months.The QRS duration,cardiac function indicators,the changes in heart rate and hemodynamics,pacemaker parameters,quality of life and adverse cardiovascular events were compared between the two groups.Results:The QRS duration was shorter;the left ventricular ejection fraction,heart rate,beats per beat,cardiac index,maximum left ventricular filling rate in early and late diastolic period,R-wave amplitude and the scores of all items in life quality were higher,and the enddiastolic diameter and end-systolic diameter of left ventricular,voltage threshold,the incidence of adverse cardiovascular events were lower in the observation group than the control group(P<0.05).Conclusion:Pacemaker implantation in the right ventricular septum is more effective in the treatment of AVB and can protect cardiac function,reduce the impact on cardiac hemodynamics and the risk of adverse cardiovascular events and improve the quality of life of the patients.

关 键 词：房室传导阻滞 右室间隔部 右室心尖部 心脏起搏器 心功能 

分 类 号：R654.2[医药卫生—外科学] R541.76[医药卫生—临床医学]