先天性室间隔缺损封堵术的心律失常及其变化探讨

The Research of the Change of Arrhythmia after Congenital Ventricular Septal Defect Closure

目的通过观察封堵术治疗先天性室间隔缺损(VSD)前后心律失常的变化,探讨术后新发心律失常的类型及对患者预后的影响.方法选择在昆明医学院附属延安医院心内科2007年1月至2009年10月成功进行导管封堵术治疗VSD的183例临床资料进行研究,分别于封堵术前1d及术后1周记录12导联同步心电图,由同一心电专业人员分析.结果 183例中,25例(13.7%)于术前检测出右束支传导阻滞.封堵术后检测出不同类型的心律失常95例,新发心律失常70例(包括1例Ⅲ度房室传导阻滞).结论室间隔缺损封堵术后心律失常发生率明显增加,并以不同程度的房室传导阻滞在术中及术后迟发为特点。

Objective Toresearch the newtypes ofarrhythmia and their effects on the prognosis of patients after the closure through observing the change of arrhythmia before and after congenital ventricular septal defect（VSD） closure.Methods The clinic data of 183 patients with congenital VSD who successfully received closure from January 2007 to October 2009 in our hospital were analyzed.12 lead synchronous ECG was recorded and analyzed by the same professional on the first day before the VSD closure and the first week after the VSD closure respectively.Results In 183 cases,25 cases（13.7%） were detected of right bundle branch block before operation.95 cases after the VSD closure were detected of different types of arrhythmia,including 70 new arrhythmia cases（consisting one case of Ⅲ degree atrioventricular block）.Conclusions The VSD closure significantly increases the incidence of arrhythmia,which is characterized by diverse delayed degrees of atrioventricular block（A-VB） during and after operation.