频率适应性起搏器对病态窦房结综合征患者运动贮量的影响

Effect of rate adaptive pacemaker on exercise capacity in old patients with sick sinus syndome

目的:探讨频率适应性起搏器对老年病态窦房结综合征患者生活质量的影响。方法:经临床,动态心电图和运动试验心电图确诊的病态窦房结综合征患者植入永久房室全能型起搏器(DDD),于起搏器植入术后即刻以及一年后分别程控为非频率适应性起搏器模式和频率适应性起搏器模式(DDDR)。两种模式下起搏器各工作一年,动态心电图检测24h活动时心率变化,限制性活动平板运动试验观察动持续时间,最大起搏频率;超声心动图测定最大运动负荷时每搏量、心排出量。结果DDDR模式下,运动持续时间和最大心排出量较DDD模式明显增加,[(87.32±68.877)s∶(275.21±57.99)s,P<0.001;(167.31±18.28)ml/s∶(106.13±14.28)ml/s,P<0.001]。结论:频率适应性起搏器显著改善老年病态窦房结综合征患者的运动耐量。

Objective： To investigate the effect of rate adaptive pacemaker on exercise capacity in old patients with sick sinus syndrome （SSS）. Methods： Fifty old SSS patients diagnosed by clinical manifestation, Holter and treadmill test were implanted the dual chamber pacing pacemakers （DDD） respectively with adaptive demand mode （DDDR） or with- out adaptive demand mode. One year later, the exercise capacity, the pacing rate, cardiac out put were measured by tread mill test, echocardiography and Holter during exercise test and daily activities in two different modes. Results： Compared with without adaptive demand mode mode, the exercise time and cardiac out put of 40 patients with DDDR modes significantly increased [（387.32±68. 877） s . （275.21±57.99） s, P〈0. 001, （167.31±18.28） ml/s . （106.13±14. 28） ml/s, P〈0. 001]. Conclusion： The implantation of DDDR improves exercise capacity with requirement of life in the old patient with sick sinus syndrome.