心室不同起搏频率对心脏血流动力的影响及临床意义

THE EFFECTS OF DIFFERENT VENTRICULAR PACING RATES ON CARDIAC HEMODYNAMICS AND ITS CLINICAL SIGNIFICANCE

本文观察26例起搏心率为60～120次/分心室起搏病人血流动力变化及11例心室起搏病人在起搏心率为70～120次/分时核素心血池显象测定的左室 EF 变化.结果表明①大部份病人CO 与起搏心率增加的关系为抛物线曲线规律,SV 与起搏心率增加则为负相关;②最佳起搏心率个体差异很大,在设置频率响应起搏器上限心率时应实测后再选定;③心室起搏后 CO 下降者日后安装 VVI 起搏器易出现起搏器综合征;④起搏心率变化引起的 EF 变化未能客观地反映心脏收缩功能的变化。

Changes of hemodynamics were investigated in 26 patients at ventricular pacing rate of 60 to 120,and 160 bpm.Effects of increasing ventricular pacing rate on EF which were determined by gated blood poll scintigraphy were also studied in another 11 patients. It is concluded that 1)In patients with normal cardiac funexion as weU as most Patieas with cardiac insufficiency,the relation of CO with increasing pacing rate can be illustrated by parabolic curve.2)Patients whose CO reduced after ventricular pacing may suffer from pacemaker syndrome if ⅤⅥ pacemaker is implanted;3)The optimal pacing rate is markedly individualized.Selection of up-limited pacing ratc of rate response pacemaker should depend on the result of realtime measuring,and 4)EF determined by gated blood pool scintigraphy is not a good index to evaluate myocardial contractive function at various ventricular pacing rates.