不同起搏方式对病窦综合征患者房颤发生率的影响

Influence of different pacing modalities on the incidence of atrial fibrillation in patients with sick sinus syndrome

目的 比较病窦综合征患者经心室按需起搏 (VVI)和心房起搏 [包括单心房起搏(AAI)、房室双腔起搏 (DDD)和双房起搏 ]治疗术后前 5年房颤的发生率。方法 对永久性人工心脏起搏器植入术后 5年以上、资料完整的 117例病窦综合征患者进行连续随访 ,平均随访时间(69.3± 6.7)个月 ,其中VVI起搏 83例 ,心房起搏 3 4例。随访内容包括临床表现、心电图和起搏器参数等 ,部分患者有Holter检查资料 ,分析 5年内两组病例房颤的发生率。结果 病窦综合征患者心脏起搏治疗前 5年内总的房颤发生率为 17.0 9% (2 0 /117) ,其中经VVI起搏的 83例患者房颤发生率为 2 2 .89% (19/83 ) ,经心房起搏的 3 4例患者房颤发生率为 2 .94% (1/3 4) ,后者房颤的发生率显著低于前者 (P <0 .0 1)。结论 在起搏治疗的病窦综合征患者中 ,术后前

Objective To compare the incidence of atrial fibrillation (Af) in the first 5 years after implantation of single chamber ventricular pacing (VVI) or atrial pacing (AP,including AAI and DDD pacing) in the patients with sick sinus syndrome (SSS).Methods 117 cases of SSS patients who had accepted permanent pacing treatment and were continually follow up surveyed for at least 5 years were selected.Follow up surveying was carried out in 83 cases of VVI pacing and in 34 cases of AP pacing by clinical examination,electrocardiography,DCG and pacing parameter measurements.To analyse the incidence of Af in the two groups.Results The total incidence of permanent Af in the first five years after implantation of pacemaker was 17.09% (20/117).The incidence of permanent Af after VVI pacemaker implantation was 22.89% (19/83),the incidence of permanent Af after AP was only 2.94% (1/34); there was a marked significance between VVI pacing and AP pacing (P<0.01).Conclusion Among SSS patients treated with pacemaker implantation for at least 5 years,compared the patients with VVI pacing,the patients with atrial pacing had a lower incidence of atrial fibrillation.