心房按需起搏的血液动力学对比研究

Hemodynamic Study on Patients With Atrial Demand Pacing

目的：观察心房按需起搏（ＡＡＩ）型生理性起搏后的血液动力学变化及心脏功能的改变。方法：对１４例ＡＡＩ型患者采用二维脉冲多普勒超声心动图测定了起搏前后的血液动力学参数，并与同期收治的１４例心室按需起搏（ＶＶＩ）型患者进行比较。结果：ＡＡＩ型组的心脏射血分数（ＥＦ）、心搏量（ＳＶ）和心输出量（ＣＯ）分别比ＶＶＩ型组增加８．３％、１１．７％和１７．３％（Ｐ均＜０．０５）。ＡＡＩ型组起搏后心房刺激脉冲至ＱＲＳ波群间期与心搏量呈负相关（ｒ＝－０．４９８６，Ｐ＜０．０５）。ＶＶＩ型组的Ｅ峰减速时间（ＥＤＴ）显著延长（Ｐ＜０．０１），而ＡＡＩ型组无明显变化。结论：ＡＡＩ型起搏后心脏仍能保持完整的收缩和舒张功能。

Objective:The aim of this study was to investigate the hemedynamic changes and heart function after AAI pacing.Methods: Twenty eight patients (14 cases of AAI and 14 cases of VVI pacing) were studied with Doppler echocardiography to assess the hemedynamic changes before and after implanting pacemaker.Results:Comparing with the VVI group,EF,SV and CO in the AAI group increased by 8.3%,11.7%and 17.3%,respectively (p<0.05).There was a negative correlation between SR interval and SV (r=-0.4968,p<0.05)in the AAI group.EDT in the VVI grOup was significantly prolonged after implanting pacemaker,but no change in the AAI group.Conclusion:Both the systolic and diastolic heart function can be maintained after AAI pacing,