目的：通过观察无心房颤动（房颤）病史的老年病态窦房结综合征（病窦）患者在双腔起搏器植入后房颤负荷的变化，探讨心房起搏比例对老年患者起搏器植入后房颤的影响。方法采用回顾性分析的研究方法。连续入选2006年1月至2012年1月在首都医科大学附属北京友谊医院心脏中心植入双腔起搏器的患者301例，进行常规随访（3.9±1.8）年，纳入最后统计的共283例患者。随访时读取起搏器内存储信息，记录心房早搏（房早）次数、最长房颤持续时间和房颤负荷；同时获取心房、心室起搏占总心搏的比例。评价心脏结构和功能。将心房起搏比例＞66%（66%为心房起搏比例中位数）设为高心房起搏比例组（141例），心房起搏比例≤66%设为低心房起搏比例组（142例）。结果与低心房起搏比例组相比，高心房起搏比例组患者房颤负荷（最长房颤持续时间和房颤负荷中位数）更低（P＜0.05）；且房早数量要少于低心房起搏比例组（P＜0.05）；但心室起搏比例在两组之间无明显差异（P＞0.05）。术前和术后两组患者的心脏结构和功能相比，差异无统计学意义（P＞0.05）。结论对于起搏器植入后的房颤易患人群，高心房起搏比例可减少房颤事件。%ObjectiveTo determine the effect of percentage of atrial pacing on atrial fibrillation (AF) by observing AF burden in the elderly patients with sick-sinus syndrome (SSS) after dual-chamber pacemakers implantation.Methods A retrospective analysis was performed on 301 patients receiving dual-chamber pacemakers implanted in our center from January 2006 to January 2012. They were followed up for (3.9+1.8) years, and finally 283 of them were enrolled in this study. The numbers of atrial premature, longest duration of AF, AF burden, and percentages of atrial and ventricular pacing were obtained through the pacemaker during follow-up, and the structure and function of heart were evaluated. The patients were divided into 2 groups according to the percentages of atrial pacing (66% as the median of atrial pacing): the high atrial pacing group (141 cases) and the low atrial pacing group (142 cases).Results When compared with the low atrial pacing group, the high atrial pacing group had significantly lower AF burden (including the longest duration of AF and the median of AF burden), and smaller numbers of atrial premature(bothP<0.05). But no difference was seen in the percentage of ventricular pacing between the 2 groups (P>0.05). There was no obvious difference in the heart structure and function before and after implantation (P>0.05).Conclusion High percentage of atrial pacing reduces the burden of AF for the elderly SSS patients implanted with dual-chamber pacemaker.
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