VVI起搏后心房颤动的发生率及影响因素

Morbidity of atrial fibrillation and its affected factors after VVI pacing

为探讨ＶＶＩ起搏后心房颤动（Ａｆ）发生率及影响因素，分析我院２９６例ＶＶＩ起搏患者，并与同期２２例生理性起搏（ＡＡＩ５例，ＤＤＤ１７例）患者比较，发现ＶＶＩ起搏后Ａｆ发生率为２５７％（７６／２９６），而生理性起搏后Ａｆ发生率仅４５％（１／２２），有显著性差异Ｐ＜００５）。同时分析比较了ＶＶＩ起搏后Ａｆ发生率与７种影响因素的关系，发现Ａｆ发生率增加除与性别无明显关系外（Ｐ＞００５），在统计学上有显著差异的因素是：年龄较大（≥６０岁，Ｐ＜００５），术前有高血压史（Ｐ＜００１），心功能不全（＞Ⅱ级，Ｐ＜００１），左房内径较大（≥４５ｍｍ，Ｐ＜００１），病态窦房结综合征（无房室传导阻滞，Ｐ＜００５），ＶＶＩ起搏时间较长（≥３年，Ｐ＜００５）。

Analysing 318 cardiac pacing patients in our hospital,we compared 296 patients implanted VVI pacemaker with 22 patients of physiological pacing (AAI 5 cases,DDD 17 cases),found that the former morbidity of atrial fibrillation(Af) was 25.7%(76/296) but the latter was only 4.5%(1/22) after operation,this had marked significance(P<005).Meanwhile we studied 7 factors which may effect morbidity of Af after VVI pacing.The results showed that besides sex(P>005) the factors of significant difference were:age≥60 years old(P<0.05),hypertension history(P<0.01),cardiac insufficiency >Ⅱ grade(P<0.01),left atrial enlargement≥45mm(P<0.01),sick sinus syndrome(no AVB,P<0.05),long time after VVI pacing≥3 years(P<0.05).