房间隔与右心耳起搏对阻止新发房颤的探讨

To investigate atrial septum and right atrial appendage pacing for prevention of new-on atrial fibrillation

选取66例病态窦房结综合征患者,均符合双腔起搏器适应证。随机分为两组,一组为右心耳(RAA)起搏36例,另一组为低位房间隔(LAS)起搏30例,随访12个月。LAS组房颤发生率(3.3%)较RAA(19.4%)组低;RAA组P波离散度较LAS组明显增大(P<0.01);3个月后RAA组左心房容积指数(LAVI)较LAS组大。较之RAA组,LAS组P波离散度降低、LAVI减小,在阻止新发房颤方面可能更优。

66 patients with sick sinus syndrome were enrolled in this study. All patients meeting the indications for dual chamber pacing were randomly divided into two groups： right atrial appendage（RAA） pacing group was made up of 36 patients and low atrial septal（LAS） pacing group was made up of 30 patients. Follow-up was 12 months. The incidence of atrial fibrillation（AF） was lower in LAS group（3. 3% ） compared with the RAA group（19. 4% ）;P wave dispersion in RAA group was significantly higher than that in the LAS group （P 〈 0. 01）. After 3 months of the operation, left atrial volume index（LAVI） in RAA group was significantly larger than that in the LAS group. In LAS group compared with the RAA group P wave dispersion and LAVI were significantly lower after operation in sick sinus syndrome. LAS pacing was superior to RAA pacing in preventing new atrial fibrillation.