右心室不同部位起搏的血流动力学比较

Comparison of Hemodynamics of Different Site Pacing in Right Ventricule

目的:探讨右室高位室间隔起搏与右室心尖部起搏的血流动力学不同。方法:60例缓慢心律失常患者,具有起搏器植入指征。随机分组,分别行右室高位室间隔起搏(A组)及右室心尖部起搏(B组)治疗。分别于术前、术后行心电图,超声心动图检查。观察QRS波时限,左心室射血分数(LVEF),左室舒张末期内径,每搏量(Sv),E峰值,E/A值,二尖瓣返流量。结果:右室高位室间隔起搏,与右室心尖部起搏比较,QRS波时限增宽程度小,LVEF以及Sv降低程度小。结论:右室高位室间隔起搏比右室心尖部起搏更接近生理性起搏,对血流动力学的不利影响较小,可能是一个更佳的起搏部位。

Objective： To evaluate the different effect of hemodynamics between right high-interventricular septal pacing （RHIVSP） and right ventricular apex pacing （RVAP）. Methods： Sixty slow arrhythmic patients with indications of pacing were divided into group A and group B randomly. Patients in group A received permanent pacing in right high-interventricular septum,while group B patients received permanent pacing in right ventricular apex. The duration of QRS,left ventricular ejection fraction（LVEF）, left ventricular end-diastolic dimension（LVEDD）, stroke volume（Sv） ,E peak（E）, A-peak velocity of mitral valve,and ratio between E and A（E/A）,volume of mitral regurgitation were assessed by electrocardiogram and echocardiogram before and after pacemakers implantation respectively. Results： The duration of QRS increased slightly, and LVEF and Sv were less decreased in RHIVSP than that in RVAP. Conclusion： Compared with RVAP, RHIVSP is more appropriate for physiologic pacing. RHIVSP has little negative effect on hemodynamics, and may be a better pacing site.