病态窦房结综合征患者文氏点的变化

ATRIOVENTRICULAR WENCKEBACH POINT PROGRESSION IN SICK SINUS SYNDROME

用食管调搏法回顾性地观察了38例病窦患者房室传导文氏点(WP)的发展情形。随诊12～141个月,平均62.5个月。初测WP≤130次/分组中WP下降的例数略多于初测WP>130次/分组(55.6%比17.2%,P<0.05)。10例(26.3%)文氏点下降,平均下降13次/分。全组患者无一例出现临床上的房室传导阻滞。SNRTm的延长与文氏点的下降没有相关性(P>0.05)。本资料结果表明,AAI型起搏器可以较多地应用于无明显房室传导阻滞的病窦患者。

The important reason for not utilizing AAI pacemaker frequently in sick sinus syndrome is the risk of further progression to AV block. We followed the Wenckebach point (WP) progression in 38 patients retrospectively with transesophageal pacing for an average of 62.5 months, and found that there were no obvious decline of WP in both WP≤130 bpm and WP≥130 bpm groups (p>0.05). Of the 38 patients, 10 (26.3%) had their WP decreased, but the progession was very slow with mean WP decreased 13 bpm in a mean follow-up period of 54. 5 months. No obvious AV block occurred. The prolongation of SNRTm had no obvious relationship with the decline of WP (p>0.05). So AAI can be used more widely among patients with sick sinus syndrome without obvious AVconduction disorder.