右室间隔上部起搏对左室功能的影响

The effect of high right ventricular septum pace-making on left ventricularfunctions

目的探讨不同的起搏部位对左室功能的影响。方法选择需要更换人工永久性起搏器患者11例。手术前起搏电极均位于右室心尖部(RVA)。手术更换起搏器,采用螺旋电极,均置放于右室间隔上部(RVS)。术后1周,程控起搏器功能参数,使起搏器工作模式为VVI、频率与术前频率相同。超声心动图检查,比较前后数据变化,并统计学处理。结果右室心尖起搏与右室间隔上部起搏比较:每搏量(ml)由58.8±19.42上升到67.2±15.8(P<0.05);心输出量(L/min)由4.93±1.30上升到5.40±0.86(P<0.05);射血分数(%)由45.2±7.3上升到53.1±5.4(P<0.05);E峰(mm/s)由57.43±15.18上升到66.35±13.73(P<0.02);E/A由0.89±0.4上升到1.04±0.37(P<0.02)。结论右室间隔上部起搏有利于左心功能的维持,尽可能保持正常心室激动顺序具有重要意义。

Objective To study the effect of different position pace making on left ventricular functions. Methods 11 patients with artificial pace making to be replaced were selected. The pace making electrodes were at the edge of the right ventricle before operation. The electrodes were placed at high right ventricular septals when pace makers were replaced. One week later,adjust the frequency of the program controlled pace makers to the same level before operation and it were worked on VVI. Inspect with ultrasonic cardiogram. Compare the data and process statistically. Results Comparison between rightventricle edge pace making and high sequence ventricular septal pace making: SV from 58.8±19.42 to 67.2±15.8 (P<0.05);CO from 4.93±1.30 to 5.40±0.86 (P<0.05); EF from 45.2±7.3 to 53.1±5.4 (P<0.05); E from 57.43±15.18 to 66.35±13.73 (P<0.02); E/A from 0.89±0.4 to 1.04±0.37 (P<0.02). Conclusion High right ventricular septal pace making improves the functions of the left ventricle and is significant in keeping the normal ventricular exciting sequence.