右室中间隔起搏患者长期预后的研究

Long-term effect of mid-septal or apical pacing on clinical outcomes after permanent pacemaker implantation

背景长期心尖部起搏患者血流动力学和临床疗效差。目的评价右室中位间隔部与心尖部起搏对患者预后的影响。方法:将入选患者分为右心室心尖部组(RVAP组)和右室中位间隔部组(RVSP组),经过长期随访后比较两组患者术后全因死亡率、新发心衰和新发房颤发生率。结果:经过46.9±9.6个月随访,RVSP组与RVAP组全因死亡率差异无统计学意义(p>0.05)。与RVAP组比较,RVSP组新发心衰和新发房颤显著下降(p<0.05)。多因素回归分析表明,RVAP新发心衰的独立危险因素。结论:RVSP患者长期预后较好,可作为RVAP的替代起搏位点。

Background Chronic fight ventrieular apical pacing （RVAP） has been associated with negative hemodynamic and clinical effects. Objective The aim of the present study was to compare RVAP with right ventricular septal pacing （RVSP） in terms of clinical outcomes. Methods The patients were divided into 2 groups： right ventrieular apical pacing （RVAP） and right ventrieular mid-septal pacing （RVSP） .Two groups were compared with all-cause morality and new on-set HF and AF. Results After 46.9 ± 9.6 months follow-up, for all-cause mortality, there were no significant different （p 〉0.05） in two groups . RVSP was associated with decreased new on-set atrial fibrillation and heart failure compared to the RVAP（p 〈0.05）. As a result of multivariate Cox proportional hazard analysis, RVAP was assoeiated with a rise of new on-set HF. Conclusion RVSP have a better clinical outcome, and could represent an alternative pacing site to RVAP.