起搏器自动化功能对右室起搏比率及心功能的近期影响

The short-term effect of automated pacemaker function on the proportion of right ventricular pacing and heart function

目的观察具备起搏模式策略(MVP)和AV间期延长的策略(Search AV+)功能的起搏器(Adapta)的临床应用效果。方法 34例患者入选。分别置入具有自动化功能的Adapta起搏器(实验组,n=18)和其它类型双腔起搏器(对照组,n=16)。并分别在置入前及置入后1,3个月进行随访。随访中观察上述两组的右室起搏比例、心功能(纽约心功能分级、血脑钠肽)、左房内径、左室舒张末内径、左室射血分数、心室收缩同步性及生活质量等的变化。结果置入双腔起搏器术后1个月及3个月,与对照组比较,实验组心室起搏比例明显降低(40.21%±46.01%vs 98.52%±2.70%;39.10%±42.00%vs 96.01%±4.34%,P均<0.05)。其他指标,两组间无明显差别。结论起搏器自动化功能可以短期内有效降低心室起搏比例。

Objective To find out the clinical effect of pacemaker which has both pacing mode （MVP） and the AV interval prolongation strategy （Search AV ＋ ） function. Methods Thirty-four patients were respectively selected into this clinical trial and implanted with the pacemaker which has both pacing mode （MVP） and the AV interval prolongation strat- egy （ Search AV ＋ ） function （ experimental group, n = 18 ） and other types of dual-chamber pacemaker （ control group,n = 16）. Evaluated the short-term efficacy （before implantation and at 1,3 month after implantation） of experimental group compared to control group on the pacing proportion of right ventricle, cardiac function （ New York Heart functional class, blood B-type rmtriurefic peptide）, left atrial diameter, left ventrieular end-diastolic diameter, left ventrlcular ejection fraction, contraction synchronicity of ventricle, quality of life and other changes. Results 1 and 3 month after implantation, the pacing proportion of right ventrictdar of experimental group decreased significantly compared with that of control group （40.21% ±46.01% vs 98.52% ±2.70% ;39.10% ±42.00% vs 96.01% ±4. 34% ,all P 〈0.05）. Conclusion Automated pacemaker function can effectively reduce the proportion of ventricular pacing in short-term. And parameters were no differences between the two groups.