特殊心房起搏程序预防和治疗阵发性心房颤动的临床效果

The clinical effect of atrial pacing algorithms on prevention and treatment of paroxysmal atrial fibrillation.

目的评价特殊心房起搏程序预防和治疗阵发性心房颤动(PAF)的临床效果。方法12例病窦综合征合并PAF患者植入Vitatron Selection 900E(AF2.0、DDDR)型双腔起搏器,比较患者术后不同阶段PAF的发作总数、持续时间、AF负荷和心房起搏比率。结果除1例外,其余11例术后第2个月和第6个月(起搏预防阶段)比术后第1个月(监测阶段)的PAF事件数[80(25;215),57(12;102)vs 203(86;425)],房颤总持续时间[1.9 d(0.6d;5.3 d),1.5 d(0.3 d;6.1 d)vs 2.9 d(0.8 d;9.8 d)],AF负荷[6.3%(2.0%;17.7%),5.0%(1.0%;20.6%)vs 9.6%(2.7%;32.8%)]均减低(P均<0.05),心房起搏比率增加[60%(40%;80%),54%(42%;84%)vs46%(26%;54%),P<0.05]。结论预防性心房起搏程序可以减少PAF事件的发生,降低AF负荷,改善患者的症状,具有短期的疗效。

Objective To evaluate the clinical effect of atrial pacing algorithms on prevention and treatment of paroxys- mal atrial fibrillation （PAF）. Methods Twelve patients with sick sinus syndrome and PAF were implanted with Vitatron Selection 900E（AF2. O,DDDR） pacemaker. After implantation patients were followed up every month to compare the num- bers of PAF episodes stored, AF total duration, AF burden and atrial pacing rate in the monitoring phase and preventive pacing phase. Result Except for one patient, the median number of PAF episodes stored[80（25;215） ,57（12;102） vs 203 （ 86 ;425 ） ], the median AF total duration [ 1.9 d （0.6 d ;5.3 d）, 1.5 d （0.3 d ; 6.1 d） vs 2.9 d （0.8 d ;9.8 d） ] and the median AF burden[ 6.3% （2.0% ; 17.7% ）, 5.0% （ 1.0% ;20.6% ） vs 9.6% （2.7% ;32.8% ） ] of other patients were significantly decreased in.the second month and the sixth month after implantation （preventive pacing phase） com- pared with those in the first month after implantation （monitoring phase） （P all 〈 O. 05 ）, while atrial pacing rate [ 60% （40% ;80% ） ,54% （42% ;84% ） vs 46% （26% ;54% ） ]was significantly increased （P 〈0.05）. Conclusion Atrial- based preventive algorithms can decrease the number of PAF episodes and AF burden, as well as reduce symptoms. It has short-term therapeutic effect. [ Chinese Journal of Cardiac Pacing and Electrophysiology, 2008,22 （ 5 ） ： 417 - 419 ]