右室间隔部起搏与右室心尖部起搏对患者心功能的影响

摘要

目的 探讨右室间隔部起搏(right ventricular septum pacing,RVS)与右室心尖部起搏(right ventricular apex pa-cing,RVA)对心功能的影响.方法 45例Ⅲ度或高度房室传导阻滞或病态窦房结综合征行永久起搏器置入患者分为RVA组(24例)与RVS组(21例).随访术后不同时期超声心动图,监测左室射血分数(LVEF)、左室舒张末期内径(LVDd)、左室Tei指数变化.结果 RVA组术后LVEF与术前比较呈逐渐降低趋势,LVDd呈持续增大趋势,差异有统计学意义(P<0.05).RVS组术后LVEF、LVDd与术前比较均无明显变化,差异无统计学意义(P>0.05).两组Tei指数在术后均持续增大,术后1天、12月与24月组间比较差异有统计学意义(P<0.05).结论 右室间隔部起搏较右室心尖部起搏对左心功能影响更小.%Objective To evaluate the effect of right ventricular septum pacing(RVS)or right ventricular apex pacing(RVA) on cardiac function. Methods Forty-five patients with Ⅲ-degree alriovenlricular btock or high-degree atriovenlricular btock or sick sinus syndrome were randomized divided into RVA or RVS groups( P < 0. 05 ) . The changes of left venlricular ejeclion fraclion( LVEF) , left venlricular diameler( LVDd) , Tei index during foltow-up were evaluated by using echocardiography. Results after 12 and 24 months of implanlalion of pacemakers,LVEF and LVDd were unchanged in the RVS group,but LVDd was increased and LVEF was decreased in RVA group patients. At the first day, 12 months and 24 months after implanlalion of pacemakers, there were significant differences in Tei index between RVS and RVA groups (P< 0. 05). Conclusions RVS treatment is more beneficial to venlricular function than RVA.