病窦综合征患者双腔起搏器植入术后PAV间期的优化

摘要

目的：研究病态窦房结综合征患者植入双腔起搏器后，心房起搏至心房除极波延迟时间对设置起搏器PAV间期的作用。方法通过随访2008年1月～2013年6月在惠州市中心人民医院安装双腔心脏永久起搏器的病态窦房结综合征的63例患者，调整PAV设置，对比出厂PAV设置，观察右心室起搏百分比变化，同时检测血浆BNP浓度。结果延长PAV间期后，与出厂设置PAV对比，心室起搏百分比可显著减少，同时BNP浓度也随之下降。结论表明SSS患者双腔起搏器植入术后，设置起搏器PAV间期要将心房起搏至心房除极波延迟时间计算在内，降低心室起搏比例同时降低患者心衰发生率。%Objective To investigate the effect of atrial pacing to atrial depolarization wave delay on setting PAV intervals after permanent dual-chamber pacemaker implantation in patients with Sinus Sick Syndrome (SSS).Methods We followed 63 patients with SSS who received a permanent dual-chamber pacemaker implantation in the hospital. We adjusted the PAV settings to compare with the original factory set, and then observed the percentage variation of RVAP and detected plasma concentration of BNP.Results Comparing with factory set of PAV, the extended PAV has maken the percentage variation of RVAP significantly reduced as well as the BNP concentration in plasma.Conclusion This evidence shows that atrial pacing to atrial depolarization wave delay time should be taken into account while setting PAV intervals for patients with SSS, in order to reduce the RVAP percentage and the incidence of heart failure.