不同右室起搏比率对房颤合并长R-R间期患者左心功能的影响

Clinical Observation of Left-Ventricular Function to Rightventricular Pacemaker Ratio in Patients with Atrial Fibrillation with Long R-R Interval

目的:观察单腔起搏器不同右室起搏比率对心房纤颤合并长R-R间期患者左心功能的影响及可能机制。方法:将24例持续性心房纤颤长合并R-R间期患者置入永久单腔心脏起搏器,根据右室起搏比率(Vp%)是否≥40%分为两组,病例组(Vp%≥40%)及对照组(Vp%<40%)。分别在出院前、1年、2年时随访,测定右室起搏比率,左心房内径(LAD),左室舒张末内径(LVEDD),左室射血分数(LVEF)。结果:两组在出院前LAD比较差异无统计学意义;病例组LAD在1年及2年时比较,差异有统计学意义;对照组与病例组的LAD变化趋势比较,有显著性差异;两组患者出院前与术后1年的LVEDD差异无统计学意义,两组LVEDD1年与2年时比较差异有统计学意义,两组2年时的LVEDD比较有统计学意义,两组LVEDD变化趋势比较有统计学意义;病例组LVEF的出院前、术后1年、2年改变有统计学意义。两组出院前、1年、2年时LVEF变化趋势无统计学意义。结论:右室起搏比率≥40%对于心房纤颤长合并R-R间期患者,引起LAD,LVEDD扩大,LVEF下降。

Objective： To explore observational single-chamber paceinaker ratio on left ventricnlar function and its possible mechanism.Method： 24 cases successfully implanted a permanent single-chamber pacemakers were divided into two groups with Right-ventrieular Pacemaker ratio greater or less than 40%.after implantation, before discharge, 1 year, 2 years of follow-up determination the ratio of right ventricuar pacing, left atrial diameter （ LAD ）, left ventricular end diastolic diameter （ LVEDD ） and left ventricular ejection fraction （ LVEF ） .Result： Two groups of left atrial diameter （ LAD ）, the difference was not statistically significant; the two groups at before dlscharge, 1 year compared to 2 years, the difference was statistically significant to 1 year and 2 years in Variation Trend of LVEDD and ejection fraction （ LVEF ） ; the difference statistically significhnt to comparison of two group in variation trend of LVEDD; no significant difference in variation trend of LVEF.Conclusions： Right-ventricular Pacemaker ratio with greater than 40% can increase left ventricular enlargement and the decline in cardiac function in patients with atrial fibrillation with long R-R interval.