预防病态窦房结综合征心房颤动的心脏起搏模式探讨

Study of cardiac pacing mode to prevent atrial fibrillation in sick sinus syndrome

目的 :观察何种心脏起搏模式能有效预防病态窦房结 (病窦 )综合征心房颤动 (房颤 )的发作。方法 :对 4 5例安置心房按需起搏器 (AAI)及房室顺序起搏器 (DDD)的病窦综合征房颤患者进行了平均 3.3年的随访观察。结果 :4 5例病窦患者仅 1例出现房颤 (2 .2 % )。对 5个典型病例进行分析的结果提示 ,超速持续心房起搏可以抑制病窦患者房颤的发生。结论 :心脏起搏抑制房颤发生的机制可能与快频率起搏加速心房内传导、抑制了房性期前收缩、消除了窦性心动过缓和心脏长 短间歇有关。

Objective:To observe what cardiac pacing mode can prevent atrial fibrillation (AF). Methods:A follow up was carried out in 45 SSS patients with AAI or DDD pacing. The mean follow up time was 3.3 years. Results:AF occurred only in 1 patient ( 2.2 %). The analysis for 5 typical cases showed that the continual atrial overdrive can prevent AF in SSS patients. Conclusion:Atrial overdrive can prevent AF, which may results from accelerating interatrial conduction, inhibiting atrial premature beat, eliminating sinus bradycardia and long short interval. AAT biatrial pacing may be a fine cardiac pacing mode to prevent AF.