双腔起搏对Ⅲ°房室传导阻滞患者心房率的影响

Effect of dual chamber pacing on atrial rhythm in Ⅲ° atrioventricular block patients

目的探讨永久双腔起搏治疗对Ⅲ°房室传导阻滞患者心房率的影响。方法回顾性选择2015年6月～2018年6月山西省人民医院心内科成功实施永久起搏器置入术的Ⅲ°房室传导阻滞患者46例,所有患者术前以及术后连续3d进行静息标准十二导联心电图检查。记录每份心电图P波以及QRS波频率,并将每日P波以及QRS波频率进行对比。同时记录并分析每例患者的一般情况,包括性别、年龄、合并的基础疾病等。结果 46例Ⅲ°房室传导阻滞患者中,术前窦性P波频率60～88(73.4±6.2)次/min,室性逸搏频率30～50(41.9±5.6)次/min。术后第1天在未用任何抗心律失常药物基础上,窦性P波频率降至60～80(66.7±4.8)次/min,较术前明显降低,差异有统计学意义(P<0.01)。术后第2天以及第3天窦性P波频率仍有下降趋势,分别为60～72(65.6±3.7)次/min,60～71(64.8±3.1)次/min,但速度已放缓,仍较术前明显降低,差异有统计学意义(P<0.01)。结论双腔起搏可改善Ⅲ°房室传导阻滞患者心功能,降低心房率。

Objective To study the effect of permanent dual chamber pacing on atrial rhythm inⅢ°atrioventricular block patients.Methods The clinical parameters of 46Ⅲ°atrioventricular block patients who underwent permanent dual chamber pacemaker implantation in our hospital were retrospectively analyzed.The patients underwent standard 12-lead electrocardiography for 3 consecutive days before and after operation.The frequencies of P wave and QRS wave on ECG were recorded and compared.The clinical parameters of patients were analyzed,including gender,age and complicated underlying diseases.Results The frequency of sinus P wave and ventricular escape beat was 60-88(73.4±6.2)/min and 30-50(41.9±5.6)/min respectively in the 46 patients before operation.The frequency of sinus P wave was reduced to 60-80(66.7±4.8)/min on day 1 after operation without use of any antiarrhythmic drugs,which was significantly lower than that bofore opreation(P<0.01).The frequency of sinus P wave was 60-72(65.6±3.7)/min and 60-71(64.8±3.1)/min respectively on days 2 and 3 after operation.However,its decreasing speed was slower after operation than before operation(P<0.01).Conclusion Dual chamber pacing can improve the cardiac function and reduce the atrial rhythm inⅢ°atrioventricular block patients.