右心房起搏术与双心腔起搏术在病态窦房结综合征患者中的疗效比较

The Clinical Effects of AAI Pacing and DDD Pacing in Patients with Sick Sinus Syndrome

目的:观察右心房起搏术(AAI)与双心腔起搏术(DDD)在病态窦房结综合征(SSS)患者中的疗效。方法:74例患者分为AAI组(共36例,其中男性14例,女性22例;平均66.8±7.9岁)和DDD组(3共8例,其中男性16例,女性22例;平均65.8±9.7岁),回顾分析比较两组心功能变化、房颤、房室传导阻滞和缺血性脑卒中的发生率。结果:心动超声心功能测定,术前和随访结果比较:左室射血分数(LVEF)AAI组从(55.8±3.1%)上升至(56.5±2.4%)(P>0.05)。DDD组LVEF从(55.5±2.8%下)降至(54.7±2.8%)(P>0.05)。比较两组患者在心功能、房颤、房室传导阻滞和脑卒中的发生率均无统计学差异。结论:对房室传导功能正常的SSS患者,与DDD比较,安装AAI起搏器不仅手术方法简单、疗效确切、并发症少,而且价廉。

Objective：To observe the clinical effects of a single chamber atrial （AAI） pacing and a dual chamber （DDD） pacing in patients with sick sinus syndrome and normal atrio-ventricular conduction. Methods： A total of 74 patients with sick sinus syndrome and normal atrio-ventricular conduction were included in this retrospective study divided into two groups, AAI pacing was performed in 36 patients （male 14, female 22, mean age 66.8± 7.9 years） and DDD pacing in 38 patients （ male 16, female 22, mean age 65.8 ± 9.7 years）. Effects were evaluated by parametes of heart function and the incidence of atrial fibrillation, atrio-ventricular block and ischemic stroke. Results：To compare pre-operation and after follow-up,left ventricular ejection fraction （LVEF） was improved by Dopplar echocardiography from （55.8 ± 3. 1 ） % to （ 56.5± 2.4） %（ P〉 0.05） in AAI pacing;LVEF was decreased from （55.5 ± 2.8） %to （54.7 ± 2.8） % （P〉0.05） in DDD pacing as well. During all cases, atrioventrieular block was in none, clinical symptoms were improved. The episodes of atrial fibrillation and ischemic stroke were no significant statistic differences（P〉0.05） between two groups. Conclusion：AAI pacing for patients with normal atrio-ventricular conduction and sick sinus syndrome may be a wise choice. The implantation of atrial demand pacemaker was a simple operation with good clinical outcome, little complication and cheap price.