右室流入道间隔部起搏对心内膜损伤的观察

Effect of right ventricular inlet septum pacing on the endocardial lesions

目的探讨右室流入道间隔部起搏对心内膜的影响。方法 64例随机分为右室流入道组(33例)和右室心尖部组(31例),观察起搏前和后1、3个月时的Ⅱ导联QRS波时限、起搏参数(起搏电压域值、电极阻抗)及血浆CKMB(肌酸激酶)、TNI(肌钙蛋白Ⅰ)、MYO(肌红蛋白)水平、IL-6(白介素-6)浓度变化。结果两组起搏参数研究期间均稳定且差异无统计学意义,流入道组QRS时限明显短于心尖组(P<0.05)。两组血浆心肌损伤标志物和IL-6浓度均较起搏前增加(P<0.05),但组间差异无统计学意义,且随时间延长渐降低。结论右室流入道间隔部起搏对心内膜的影响与心尖部起搏相似,但较右室心尖部起搏更符合生理性。

Objective To evaluate the effect of right venlricttlar inlet septarn pacing on patients with endocardial lesions. Methods VVI pacing was performed in 64 patients who were grouped randomly into two groups： RVIS（33 patients） and RVA（31 patients）. The following parameters were observed one month and three months before and after pacing, when the heart was paced effectively ： the ECG 11 lead QRS wave duration, pacing parameters （pacing voltage threshold, electrode impedance） and plasma CKMB （creatine kinase MB）, TNI （troponin I）, MYO （myoglobin） levels and IL -6 （Interleukin -6） concentration. Results Pacing parameters in both groups during the study were stable and were not significantly different. The QRS duration in RVIS group was significantly shorter than in RVA group （P 〈0.05）. The plasma markers of my^ardial injury and interleukin -6 concentrations were higher than before pacing in the two groups （P 〈0. 05）, but without significant difference between the two groups, and gradually decreased with pacing time. Conclusi on Right ventricnlar inlet septum （RVIS） pacing has a similar effect on endocardium to apex pacing , but is more in line with physiology.