RVSP与RVAP起搏对CAVB患者心功能的影响

目的分析右室间隔起搏(RVSP)与右室心尖部起搏(RVAP)对完全性房室传导阻滞(CAVB)患者心功能的影响方法回顾性分析127例因CAVB行永久起搏器植入术、术前左室射血分数(LVEF)M50%、术后起搏比例M40%、随访Ml年并进行心超、心电图检查的患者,依据右室电极植入部位分为RVAP组50例,RVSP组77例。采集所有病例的临床基线数据(包括性别、植入时年龄、合并疾病)、植入前/后LVEF、植入前/后左室舒张末期直径(LVIDd)、自身/起搏QRS时限,并进行统计分析。结果RASP组起搏QRS波时限为(166.42±14.61)ms,明显大于RVSP(160.14±9.75)ms(P<0.05)。术后出现有临床意义的LVEP下降RASP组为10%、PVSP组为10.39%,两者差异无统计学意义(P>0.05)。结论间隔起搏与右室心尖起搏相比,起搏QRS时限短,但对心功能的影响无明显差异。

Objective To assess the impact of right ventricular septal pacing verse right ventricular apical pacing on the cardiac performance of the patients with complete atrioventricular block.Methods 127 patients with normal left ventricular ejection fraction and undergoing pacemaker implantation due to CAVB were retrospectively studied,whose frequent M40%RV pacing was present and repeat electrocardiography and echocardiography were available.According the lead location,they were divided into RVAP group(n=50)and RVSP group(n=77).The clinical data included patient demographic characteristic,medical history,electrocardiographic and echocardiographic findings were collected and analyzed.Results The RASP group showed longer paced QRS duration than RVSP group[(166.42±14.61)ms vs(160.14±9.75)ms P<0.05].There's no difference of the LVEF reduce after implantation between RASP group and RVSP group(10%vs 10.39%P>0.05).Conclusion Compared to RASP,RVSP has no remarkable benefit in LVEF conservation in patients with CVAB.