右室心尖部和右室流出道间隔部起搏对心功能和左心室收缩同步性的影响

Effects of septal pacing of right ventricular apex and right outflow tract on cardiac function and synchronization with left ventricular contraction

目的:比较右室心尖部(RVA)和右室流出道(RVOT)间隔部起搏对心功能和左心室收缩同步性的影响。方法:选择原为心室起搏(VVI)心尖部起搏、现需更换起搏器的患者2例和心动过缓需安装起搏器的新患者33例,共35例。评估QRS波宽度、S-QRS间期,并行常规超声心动图(UCG)检查,测左室射血分数(LVEF)、左室短轴缩短率(FS)。测量左室12个节段的QRS波起始点至各节段收缩期达峰时间(Q-Ts)和左室12个节段的Q-Ts最大差值(Max-ΔTs)。结果:RVOT起搏组的S-QRS间期较RVA起搏组缩短[(31.35±7.27)msvs(54.35±9.03)ms](P<0.05)。RVOT起搏组的QRS时限较RVA起搏组缩短[(72.44±10.36)msvs(91.47±10.56)ms](P<0.05)。与RVOT起搏相比,RVA起搏术后1d的LVEF、FS均降低(P<0.05)。RVA起搏组的左室各壁基底段和中间段Q-Ts与RVOT起搏组相比,均延长(P<0.01)。结论:RVOT起搏较RVA起搏对左室收缩功能的影响小,是一种较为理想的起搏部位。

Aim:To study differences of right ventricular apex (RVA) and the right outflow tract (RVOT) spetal paceing of cardiac function and synchronization with left ventricular contraction.Methods:A total of 2 cases of pacemaker patients for the apex VVI pacing to be replaced and 33 cases of bradycardia to install a pacemaker were collected.QRS width,S-QRS interval,parallel conventional echocardiography (UCG) inspection,and LVEF,FS were detected.Left ventricular 12 segments of the QRS complex starting point to sect...