两种起搏方式对单纯病态窦房结综合征患者心功能及房性心律失常的影响  

Effects of two pacing modes on cardiac function and atrial arrhythmia in patients with simple sick sinus syndrome

作　　者：任琳子 杨淑 罗超 马妮娜[1] 车奕宏 REN Lin-zi;YANG Shu;LUO Chao;MA Ni-na;CHE Yi-hong(The First Department of Cardiology,Hanzhong Central Hospital,Hanzhong 723000,Shaanxi,CHINA)

机构地区：[1]汉中市中心医院心内一科,陕西汉中723000

出　　处：《海南医学》2023年第20期2911-2915,共5页Hainan Medical Journal

基　　金：国家自然科学基金(编号:81100070)。

摘　　要：目的 比较两种起搏方式对单纯病态窦房结综合征(SSS)患者心功能及房性心律失常的影响。方法 回顾性分析2019年1月至2022年1月期间就诊于汉中市中心医院的92例SSS患者的临床资料,根据起搏方式不同将其分为低位房间隔组49例(采用低位房间隔起搏)和右心耳组43例(采用右心耳起搏)。比较两组患者术前及术后6个月的心功能[左室射血分数(LVEF)、心室舒张早期和心室舒张末期时的血流流速比值(E/A)、左心房容积指数(LAVI)]和心电图表现(P波时限、P波离散度、窦房结传导时间)(SACT);随访6个月后,比较两组患者随访期间术后心脏不良事件(房性心律失常、心力衰竭)和术后并发症发生情况。结果 术后6个月,两组患者的LVEF、E/A较术前均明显升高,LAVI较术前明显降低,且低位房间隔组的LVEF、E/A分别为(50.28±5.39)%、1.20±0.15,明显高于同时间右心耳组的(47.16±4.21)%、1.12±0.17,低位房间隔组的LAVI为(32.27±2.28) mL/L^(2),明显低于同时间右心耳组的(34.01±2.54) m L/L2,差异均有统计学意义(P<0.05);术后6个月,低位房间隔组患者的P波时限、P波离散度明显较术前降低,而右心耳组患者的P波时限、P波离散度分别为(129.48±7.12) ms、(32.73±5.02) ms,与其术前比较明显升高,且相同时间低位房间隔组患者的P波时限、P波离散度分别为(119.13±8.54) ms、(25.08±4.86) ms,明显低于右心耳组,差异均有统计学意义(P<0.05);术后6个月,两组患者的SACT均较术前显著降低,差异均有统计学意义(P<0.05),但低位房间隔患者的SACT为(142.28±4.75) ms,与右心耳组的(143.07±4.29) ms比较差异无统计学意义(P>0.05);随访6个月,低位房间隔组患者的房性心律失常发生率为2.04%,明显低于右心耳组的13.95%,差异有统计学意义(P<0.05),但两组患者的心力衰竭发生率比较差异无统计学意义(P>0.05);低位房间隔组患者术后并发症总发生率为2.04%,略低于右心�Objective To compare the effects of two pacing modes on cardiac function and atrial arrhythmia in patients with simple sick sinus syndrome(SSS).Methods The clinical data of 92 patients with SSS admitted to Han-zhong Central Hospital from January 2019 to January 2022 were retrospectively analyzed,and the patients were divided into low atrial septum group(49 cases,low atrial septal pacing)and right atrial appendage group(43 cases,right atrial ap-pendage pacing)according to the different pacing modes.Cardiac function[left ventricular ejection fraction(LVEF),ra-tio of maximal early diastolic mitral flow velocity/maximal late diastolic mitral flow velocity(E/A),left atrial volume in-dex(LAVI)],and electrocardiogram manifestations[P wave duration,P wave dispersion,sinoatrial conduction time(SACT)]before surgery and at 6 months after surgery were compared between the two groups of patients.After 6 months of follow-up,the occurrence of postoperative adverse cardiac events(atrial arrhythmia,heart failure)and postop-erative complications during follow-up were compared.Results Six months after surgery,the LVEF and E/A of both groups of patients were significantly increased compared to those before surgery,while LAVI was significantly reduced compared to that before surgery;the LVEF and E/A of the low atrial septal group were(50.28±5.39)%and 1.20±0.15,re-spectively,which were significantly higher than(47.16±4.21)%and 1.12±0.17 of the right atrial appendage group at the same time point(P<0.05).The LAVI of the low atrial septal group was(32.27±2.28)mL/L2,which was significantly low-er than(34.01±2.54)mL/L2 of the right atrial appendage group at the same time point(P<0.05).Six months after surgery,the P-wave duration and P-wave dispersion of patients in the low atrial septal group were significantly lower than those before surgery,while the two indexes in the right atrial appendage group[(129.48±7.12)ms and(32.73±5.02)ms]were significantly higher than those before surgery;the P-wave duration and P-wave dispersion of pat

关 键 词：起搏方式 单纯病态窦房结综合征 心功能 房性心律失常 

分 类 号：R541.74[医药卫生—心血管疾病]