摘要
目的:探讨心房感知起搏器(AAI)的临床应用状况和对病态窦房结综合征(SSS)患者预后的影响。方法:回顾性调查1998-2002年在长征医院进行起搏治疗的175例SSS患者的病例资料。将其中132例患者分成AAI、双腔感知起搏器(DDD)、心室感知起搏器(VVI)三组,定期门诊随访,观察房颤、中风、心力衰竭、起搏器综合征、手术并发症、起搏电极脱位、生活质量改善以及Ⅱ度以上房室传导阻滞(AVB)发生率等临床情况。结果:175例SSS患者中共有AAI适应证42%(73例),但仅有13%(22例)置入AAI起搏器。AAI组的房颤、中风、心力衰竭发生率显著低于VVI组。AAI组中未发现新发生的AVB。结论:AAI起搏较其他起搏方式更有利于SSS的预后。应该注意纠正临床上AAI起搏器应用率偏低的不合理情况。
Objectives: Investigate the clinic usage status of AAI pacemaker and the prognosis of the patients with sick sinus syndrome (SSS) received AAI pacemaker. Methods:The data of 175 paced SSS patients were retrospectively investigated and 132 SSS patients among all patients were followed-up in out-patient department according to the group of AAI, DDD and VVI pacing mode. The incidence of pacemaker syndrome, congestive heart failure, stroke, atrial fibrillation, operation complication, dislocation of electrode leads, changes of quality of life were compared among three groups. The incidence of high degree atrial-ventricular block (AVB) during follow-up in AAI group was investigated in meantime. Results:Forty-two percent (73 cases) of 175 patients were the indications of AAI pacing, but only 13 % (22cases) were implanted with AAI pacemaker. The incidence or prevalence of atrial fibrillation, heart failure and stroke in AAI paced group were significantly less than in VVI group. No new occurring AVB case was found in AAI group. Conclusions:As compared with other pacing modes, the prognosis of SSS patients was improved significantly in AAI pacing mode. We should pay an attention to rectify the situation of low AAI pacemakers’ usage in clinic.
