房室同步心脏起搏对心室舒张、收缩功能及心律失常的影响

Analysis on the Influence of Atrioventricular Synchronization Pacemaker on Ventricular Diastolic and SystolicFunction and Cardiac Arrhythmias

目的房室同步起搏器工作方式对左心室和右心室收缩/舒张功能及心律失常的影响。方法拟研究在2009年3月—2011年6月期间于我院、南充市中心医院及资阳市第一人民医院行双腔起搏器安置且的患者20例。采用患者自身对照模式(intrapatient model),对术前及术后6个月超声心动图及彩色M型超声(M-mode),24 h动态心电图变化及C型利钠肽(CNP)酶联免疫分析,分析双腔起搏器工作方式对心功能影响程度。结果起搏前后患者心室舒张、收缩功能及心律失常具有明显差异,其中QRS波时限、室间收缩同步性指标I IVMD、左心室内收缩同步性指标SPWMD及左心室射血分数LVEF显著差异具有统计意义,P<0.05。心功能指标LVEDD相比,显著差异没有统计意义,P>0.05。BNP(pg/mL)提示植入前(20.48±3.83),植入后(13.67±3.42).t=21.12,P<0.01。结论对房室同步起搏方式下心功能及心律失常变化趋势的研究将有助于寻找该类患者心功能及心律失常的变化特征,由此针对可能出现的心功能不全及不良心血管事件做到前瞻性预防及治疗,值得临床推广。

Objective The atrioventricular synchronization pacemaker works of left ventricular and right ventricular systolic/diastolic function and the influence of cardiac arrhythmias. Methods To study in March2009- June 2011 in our hospital during the period of line, nanchong central hospital and ziyang city first people＇s hospital double chamber pacemaker placement and 20 cases of patients. Using the patient＇s own control mode（intrapatient model）, 6 months of preoperative and postoperative echocardiography and color M type ultrasonic（M-mode）, 24 hours dynamic electrocardiogram（ecg） changes and c-type natriuretic peptide（CNP） enzyme-linked immunoassay, analysis of dual chamber pacemaker works impact on cardiac function. Results Before and after pacemaker in patients with ventricular diastolic and systolic function and cardiac arrhythmias has significant difference, The QRS wave duration, interventricular systolic synchrony index I IVMD, left ventricular systolic synchrony index of SPWMD and left ventricular ejection fraction LVEF significant difference has statistical significance,P〈0. 05. Compared with the heart function index LVEDD, significant difference was not statistically significant,P 〉0.05. BNP（pg/ml） TIPS implantation before 20.48 ±3.83,13.67 ±3.42.t =21.12 after implantation, P 〈0.01. Conclusion The atrioventricular synchronous pacing mode heart function and cardiac arrhythmia change trend of research will help to find the class changes of heart function and cardiac arrhythmias in patients with characteristics, thus for cardiac dysfunction may appear and the adverse cardiovascular events do prospective, prevention and treatment, worth clinical promotion.