单电极VDD心脏起搏治疗肥厚性梗阻型心肌病(附1例报告)

VDD Pacing System in patient with hypertrophic Obstructive cardiomyopathy:with case report

目的：用ＶＤＤ心脏起搏治疗１ 例肥厚性梗阻型心肌病（ＨＯＣＭ），并观察其临床及血流动力学效果。 方法：常规方法植入ＶＤＤ型心脏起搏系统，设置房室起搏间期１２０ ｍ ｓ，心房感知０．１５ ｍ Ｖ，起搏前后进行左室流出道压力阶差等血液动力学对比观察。 结果：术后房室同步起搏率为１００％ ，左室流出道压力阶差从６．８ ｋＰａ（５１．４ｍ ｍ Ｈｇ）降至２．８１３ ｋＰａ（２１．１ ｍ ｍ Ｈｇ），二尖瓣前移现象消失，临床症状明显改善，随访期间未再出现晕厥。 结论：ＶＤＤ起搏植入简便、房室同步功能稳定，对ＨＯＣＭ 患者不失为一种新的有效的治疗方法。

Objective: We report our clinical use of VDD pacing in one patient with HOCM and its hemodynamic effects. Methods: A permanent VDD pacing system was implanted with 120 ms A V delay and 0.15 mV atrial sensitivity. Hemodynamic parameters were observed befor and after VDD pacing. Results:The percent of atrial synchronous ventricular pacing was 100% and clinical syndromes were significantly improved with no syncope happened in the follow up of 3 months. The left ventricular outflow tract(LVOT) pressure gradients were reduced from 51.4 mmHg to 21.1 mmHg after pacing. Conclusion: VDD pacing is an effective new method to treat patients with HOCM.