右室流入道起搏治疗缓慢性心律失常44例临床研究

Clinical Study on Right Ventricula Inlet Tract Pacing Treating Bradycardia

目的采用右室流入道和传统的右室心尖部起搏两种不同的方法治疗缓慢性心律失常,观察起搏参数、并发症、心电图QRS时限和心功能的变化。方法随机将86例患者分为右室流入道起搏组44例,右室心尖部起搏组42例,分别观察两组起搏器植入时、起搏3和6个月时的起搏参数、并发症、心电图QRS时限和心功能的变化。结果两组不同时期起搏参数、并发症比较,差异无统计学意义;而右室流入道起搏组心电图QRS时限明显短于右室心尖部,心功能改善也显著优于右室心尖部,差异有统计学意义,且心功能改善随起搏时间延长呈逐步好转趋势,而心电图QRS时限不同时期时限较固定。结论采用右室流入道起搏治疗,其心功能改善明显优于传统的右室心尖部起搏,值得在临床上推广。

Objecive To survey the changes of pacing parameters,complications,QRS time limit of ECG and cardiac function by using two different methods,right ventricula inlet tract pacing and traditional right ventricular apical pacing.Method The patients（86 cases） were randomly divided into two groups：right ventricular inlet tract pacing group（44 patients） and right ventricular apical pacing group（42 patients）.The changes of pacing parameters,complications,QRS duration and cardiac function were assessed in 1 day,3 months and 6 months after implantation.Results In different stages,there was no statisitical siginificance between two groups on pacing parameters and complications,but the QRS duration in right ventricular inlet pacing group was much shorter than that in right ventricular apical pacing group,and the cardiac function improvement was also markedly better.There were statistical significances.The cardiac function trended to improve gradually along with the prolongation of the pacing time,but the QRS duration was constant in different stages.Conclusions The improvement of the cardiac function in right ventricular inlet tract pacing is markedly better than that in traditional right ventricular apical apcing.The right ventricular intet tract pacing is worth spreading clinically.