双腔起搏器对缓慢性心律失常并心力衰竭病人血流动力学的影响

Effects of dual-chamber pacemaker on hemodynamics in heart failure patients with bradycardiac arrhythmia

目的评估双腔起搏器对缓慢性心律失常并心力衰竭病人血流动力学的影响。方法对20例缓慢性心律失常心衰病人经锁骨下静脉植人DDD型起搏器，对比分析术前及术后1～2周X线胸片、放射性核素门控心室显影和超声心动图检查结果。结果所有患者临床症状及心功能明显改善，术后心胸比例、射血分数（EF）、心排血量（CO）、心脏指数（CI）均明显好转［分别为0．70±0．13vs0．61±0．12、0．29±0．09vs0．38±0．10、2．30±0．81vs3．34±0．75（L／min）、1.31±0．71vs1．98±0．49（L／min·m2），P＜0.05或P＜0．01］。结论DDD起搏器治疗能显著改善缓慢性心律失常心力衰竭病人的血流动力学，可作为治疗缓慢性心律失常并心力衰竭的有效方法之一。

Objective To study effects of dual-chamber (DDD) pacemaker on hemodynamics in heart failure patients withbradycardiac arrhythmia. Methods DDD pacemaker was implanted via subclavian vein into 20 heart failure patients withbradycardiac arrhythmia. The heart was measured using chest X-ray, gated-equilibrum radionuclide ventriculography,echocardiography before pacemaker implantation and 1-2 weeks after pacemaker implantation. Results The clinical symptoms andNYHA functional status of all the patients were considerably improved. The cardiothoracic ratio was reduced from 0.70f0.13 to0.62±0. 15 (P<0.05). but ejection fraction (EF). cardiac output (CO) and cardiac index (CI) were increased significantly after 1-2weeks pacing from 0.29±0.09 to 0.38±0. 10, 2.30±0.81 to 3.34 ±0.75 L/min and 1 .31 ± 0.71 to 1 .98 ±0.49 (L/min. m2 ).respectively (p<0.01 ). Conclusion DDD pacing has beneficial effects on hemodynamics of heart failure patients with bradycardiacarrhythmia and was an effective method for treatment of heart failure with bradycardiac arrhythmia.