永久性心房起搏治疗和预防病窦综合征伴心房颤动的长期临床研究

Long-term Clinical Studies of Prophylaxis and Treatment of Sick Sinus Syndrome with Atrial Fibrillation Through Permanent Atrial Pacing

目的 :比较心房起搏与心室起搏对病窦综合征伴阵发性心房颤动的远期临床效果。方法 :从1990年 5月～ 2 0 0 3年 7月应用心房起搏治疗和预防房颤 5 9例 ,并建立对照组为植入心室起搏组 4 2例 ,两组性别比例 ,年龄 ,病程及合并基础心脏病无统计学差异。结果 :心房起搏组房颤及慢性房颤发生率低于心室起搏组 ,单心房起搏预防房颤效果肯定 ,房颤的发生率较术前下降 39% ,与心室起搏相比房颤发生率显著下降 (P <0 . 0 1) ,并具有显著的抗心律失常作用。心房起搏组脑血管事件的发生率 ,心力衰竭及死亡率均低于心室起搏组。心房起搏组生活质量明显高于心室起搏组。结论 :永久性心房起搏能有效预防和治疗病态窦房结综合征病人房颤的发生 ,改善临床症状 ,减少脑血管事件的发生 ,避免心力衰竭的加重 ,减少死亡率 ,提高生活质量。

Objective:To compare long-term clinical studies of prophylaxis and treatment of sick sinus syndrome with atrial fibrillation between atrial pacing and ventricular pacing.Methods:59 patients with atrial fibrillation were treated and prevented by atrial pacing from May in 1990 to July in 2003,and 42 patients with ventricular pacing were used as a control group.Sex,age,course of disease and basic heart disease were no significant in two groups.Results:The incidences of atrial fibrillation and chronic atrial fibrillation in atrial pacing group were lower than that in ventricular pacing group.There was a definite prophylaxis result during single atrial pacing.The incidence of atrial fibrillation was reduced by 39% compared with the preoperation and significantly decreased compared with that in the ventricular pacing group.In addition,atrial pacing plaied an important role in antiarrythmias.The incidences of cerebrovascular events,heart failure and death rate in the atrial pacing group were reduced and the life quality of atrial pacing patients was remarkably improved compared with that in the ventricular pacing group.Conclusions:Permanent atrial pacing can be used to prevent and treat atrial fibrillation events,improve the clinic symptom,decrease cerebrovascular events,refrain from the deterorate of heart failure,reduce death rate and improve the ilfe quality of sick sinus syndrome patients.