具有自动搜索心房滞后功能的起搏器对房性心律失常近期影响研究

Recent impact study of automatic search function of the pacemaker atrial hysteresis on atrial arrhythmias

目的探讨具有自动搜索心房滞后功能的起搏器对房性心律失常近期影响,评估其临床疗效和安全性。方法选择植入Identity Adx DDD 5286型双腔起搏器病态窦房结综合征的患者43例。起搏器植入后不打开带自动搜索的心房滞后,保持起搏器出厂设置;术后3个月随访时程控为在DDD模式下打开带自动搜索的心房滞后,共随访6个月。比较起搏器植入前后及打开心房滞后模式后心房起搏百分比、动态心电图(DCG)房性心律失常发生情况。结果与术前比较术后3个月DCG24h房性早搏(简称房早)次数和房性心动过速(简称房速)、心房颤动(简称房颤)阵数增加(P<0.05);房早、房速和房颤的发作例数增加(P<0.05)。打开具有自动搜索功能的心房滞后模式与未打开该模式比较:心房的起搏百分比明显降低[0.54(0.41,0.71)vs.0.82(0.65,0.93),P<0.05];DCG24h房早次数和房速、房颤阵数明显减少(P<0.05)。房早、房速和房颤的发作例数减少(P<0.05)。结论具有自动搜索功能的心房滞后模式可以明显减少心房起搏的比例,减少房性心律失常的发生;打开具有自动搜索功能的心房滞后模式安全可靠。

Objective To explore the recent influences of pacemaker with automatic search function of atrial hysteresis on atrial arrhythmias,to evaluate its clinical efficacy and safety.Methods Identity Adx DDD 5286 implanted dual chamber pacemaker for sick sinus syndrome in 43 cases.Automatic search of atrial lag was not opened with after pacemaker implantation,and the pacemaker settings was kept.Follow-up program after 3 months,DDD mode with automatic search of atrial lag was opened,and this mods was followed up for 6 months,comparing the atrial pacing percentage and DCG atrial tachyarrhythmias of pacemaker implantation to opening atrium lag mode.Results Compared with the preoperative and operative 3 months later,DCG 24 h showed that APB and atrial tachycardia,atrial fibrillation array number increased （P ＜ 0.05） ; APB,atrial tachycardia and atrial fibrillation episodes were increased（P ＜ 0.05）.Compared with the automatic search function in atrial hysteresis model opened with and not opened：atrial pacing percentage decreased [0.54（0.41,0.71） vs.0.82（0.65,0.93）,P ＜0.05] ;DCG 24 h showed that APB,atrial tachycardia,atrial fibrillation array number were decreased （P ＜ 0.05）.APB,atrial tachycardia and atrial fibrillation episodes were reduced （P ＜ 0.05）.Conclusions Automatic search function in atrial hysteresis model can obviously reduce the proportion of atrial pacing,reduce the occurrence of atrial arrhythmias ;opened with automatic search function in atrial hysteresis model was safe and reliablely.