VVI模式下右室不同部位起搏对左室收缩同步性及心功能的影响观察
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2008年无锡市科技局社会发展项目(CSZ00805)


The effect of VVI pacing in different sites of the right ventricle on left ventricular systolic synchronicity and cardiac function
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    目的:评价VVI模式下右室间隔部起搏和右室心尖部起搏1年后对左室收缩同步性的影响-方法:选择60例只能接受VVI单腔起搏治疗且起搏依赖的患者,分为右室间隔部起搏组(RVSP组,n=30例),和右室心尖部起搏组(RVAP组,n=30例)-于术前及术后1年测定左室射血分数(LVEF),同时应用实时三维超声心动图技术获取实时三维超声心动图时间-容积曲线,评价左室收缩同步性-结果:术前两组左室收缩的同步性及LVEF无显著差异;随访1年后,RVSP组与RVAP组相比,LVEF稍有提高,但无统计学差异(P > 0.05),左室收缩同步性指标Tmsv 16-SD%-Tmsv 12-SD%明显下降,差异有统计学意义(P < 0.05)-结论:RVSP较RVAP左室收缩的同步性好,左室收缩功能影响小,更接近于生理起搏-

    Abstract:

    Objective:To investigate the effects of right ventricular apex pacing(RVAP) or right ventricular outflow tract septal pacing(RVSP) on left ventricular systolic synchronicity and cardiac function in VVI mode after 1-year of implantation. Methods:Sixty patients who were dependent on pacemaker and can only received VVI single-chamber pacemaker implantation were devided into two groups: the right ventricular apex pacing group(RVAP group, n=30) and the right ventricular outflow tract septal pacing group(RVSP group, n=30). The left ventricular ejection fraction(LVEF) was measured before and one year after operation. The time-volume curves were also recorded by real time three dimensional echocardiography (RT-3DE) to evaluate left ventricular systolic synchronicity. Results: There were no differences on left ventricular systolic synchronicity and LVEF between the two groups before operation. After one year’ follow-up, LVEF in RVSP group increased, but no difference compared with that in RVAP group(P > 0.05). However, the parameters of left ventricular systolic synchronieity(Tmsv 16-SD%and Tmsv 12-SD%) significantly decreased in RVSP group(P < 0.05). Conclusion: The RVSP pacemaker keeps better left ventricular synchronous contraction and has less negative effects on the cardiac function than RVAP pacemaker. Therefore RVSP pacemaker is in accordance with physiological pacing.

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崔俊友,张 华,高春恒,殷泉忠,易桂斌,陆 叶,李 健,王东升. VVI模式下右室不同部位起搏对左室收缩同步性及心功能的影响观察[J].南京医科大学学报(自然科学版),2011,(6):847-850

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  • 收稿日期:2010-11-16
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