起搏器心室自身优先功能对累计心室起搏比例及心功能的影响

Influence of ventricular intrinsic preference algorithm on the percentage of right ventricular pacing and heart function

目的观察具有心室自身优先(VIP)功能的起搏器对累计心室起搏比例及心脏功能的影响。方法选择因缓慢性心律失常安装心脏起搏器的患者62例。所有患者均为心房电极位于右心耳,心室电极位于右室心尖部;根据植入后是否开启心室自身优先功能分为观察组30例和对照组32例,分别在置入前及置入后12个月进行随访,观察2组累计心室起搏比例、左房内径(LAD)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)、血浆脑钠肽(BNP)水平及6 min步行试验距离。结果术后12个月,与对照组比较,观察组LAD[(39.38±4.16)mm vs(43.41±5.34)mm]、LVEDD[(47.12±7.22)mm vs(51.76±9.26)mm]显著降低,LVEF(0.60±0.08 vs 0.55±0.11)升高,6min步行试验距离[(339.79±45.82)m vs(314.38±41.74)m]更长(P<0.05),BNP水平[(108.23±62.10)ng/l vs(143.87±72.85)ng/l]显著降低(P<0.05),累计心室起搏比例(0.21±0.08 vs 0.55±0.12)明显降低(P<0.01),而房颤负荷差异无统计学意义(P>0.05)。结论 VIP功能可以明显减少累计心室起搏比例,并保护心功能。

Objective To investigate the impacts of ventricular intrinsic preference （VIP） algorithm on percentage of right ventricular pacing and heart function. Methods A total of 62 patients received permanent cardiac pacemaker for brady arrhythmias were enrolled. All patients were located in the right atria] appendage, ventricular electrode in the right ventricular apex; implant is turned on according to their own priorities ventricular function divided into observation group（30 cases） and control group （32 cases）, before and after implantation in 12 months follow-up, two groups were observed cumulative propor- tion of ventricular pacing, left a^ial diameter （LAD）, left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD）, brain natrihr^etic peptide （BNP） levels and 6 min walk test distance. Results After 12 months, compared with the control group, the observation group LAD[（39.38 ± 4. 16） mm vs. （43.41 ± 5.34） mm], LVEDD [ （47.12 ±7.22） mm vs. （51.76 ± 9.26） mm] was significantly decreased, LVEF （0.60± 0.08 vs. 0.55 ±.11） elevated, 6 min walk test distance [ （339.79 ±45.82） m vs. （314.38 ±1.74） m] was longer （ P 〈0.05）, BNP levels [ （108.23±2.10） ng/L vs. （143.87 ±2.85） ng/L] decreased significantly（ P 〈0.05）, the cumulative percentage of ventricular pacing （0.21 ±0.08 vs. 0.55 ±0. 12） was significantly lower （ P 〈 0.01 ）, and atrial fibrillation load the difference was not statistically significant （ P 〉 0.05 ）. Conclusion Ventricular intrinsic preference algorithm can effectively reduce the percentage of ventricular pacing, protect heart function.