心室起搏管理减少心室起搏比例的临床随访

Clinical Follow-up Study on the Effect and Mechanism of Managed Ventricular Pacing Algorithm on Cumulative Ventricular Pacing Proportion

目的探讨心室起搏管理(Managed Ventricular Pacing,MVP)对永久起搏器植入患者累计心室起搏比例(cumulative ventricular pacing proportion,Cum VP%)的影响。方法 (1)42例患者植入具有MVP功能的起搏器后,分别在常规DDDR和MVP两种工作状态下进行随访研究。其中先以常规DDDR状态工作1个月后,再以MVP状态工作1个月、6个月和12个月,分别计算累计心房起搏百分比(Cumulative atrial pacing proportion,Cum AP%)和Cum VP%;(2)计算在两种不同工作状态下Cum VP%小于40%的人数比例;(3)了解相关不良事件发生情况。结果 (1)传统DDDR模式工作1个月后,42例患者Cum VP%为(95.12±26.32)%。MVP模式工作下第1、6和12个月Cum VP%分别为:(19.63±44.80)%;(17.11±39.63)%;(15.62±46.80)%,(P<0.05);(2)常规DDDR工作状态下Cum VP%小于40%的人数为0;而MVP模式下随访期间分别为(95.21±7.81)%;(96.73±3.20)%;(97.70±2.80)%(P<0.05);(3)随访期间无相关不良事件发生。结论与传统DDDR模式相比,MVP模式可显著减少Cum VP%。

Objective To investigate the effect and mechanism of managed ventricular pacing （ MVP ） algorithm on cumulative ven-tricular pacing proportion（ Cum VP% ） in patients with permanent cardiac pacemakers. Methods ① Pacemakers with MVP algorithm were implanted in 42 patients including 41 with bradycardia and 1 with ventricular tachycardia. The follow-up study was conducted when the conventional DDDR mode and MVP algorithm were programmed separately. It started with conventional DDDR pacing for one month,and then MVP were performed for one month, 6 month and 12 month respectively. Cumulative atrial pacing proportion （Cum AP% ） and Cum VP% in conventional DDDR pacing and MVP algorithm were calculated.② Percentages of 42 patients’ Cum VP% less than 40% were calculated in both modes.③The special electrocardiogram changes about MVP were also performed to in-vestigate its working principle and mechanism of reducing Cum VP% . Results ① In 42 cases, Cum VP% were （ 95.12±26.32 ）% in conventional DDDR mode and （ 19.63± 44.80 ）%, （ 17.11± 39.63 ）% and （ 15.62 ± 46.80 ）% respectively in MVP algorithm during the follow-up （P〈 0.05 ）.② The percentages of Cum VP% 〈 40% in 42 cases were 0 in DDDR algorithm and （ 95.21 土 7.81）%,（ 96.73±3.20）% and（97.70±2.80）% respectively in MVPalgorithmduringthefollow-up（P〈0.05）. ③ Soad- verse events occurred in the follow-up visits. Conclusions Compared with conventional DDDR mode, the MVP algorithm significantly reduces Cum VP% .