老年希氏束-浦肯野系统起搏与右心室流入道间隔部起搏的电学参数及短期临床效果对比

Comparison of electrical parameters and short-term clinical effects between His beam-Purkinje system pacing and right ventricular inflow tract septum pacing

目的对比希氏束-浦肯野系统起搏与右心室流入道间隔部起搏对老年人的治疗效果,从而为患者治疗选择提供依据。方法选择本地三甲医院2018年1月~2019年12月符合心脏起搏器植入治疗的患者70例为研究对象,随机分为两组,每组35例,分别进行希氏束-浦肯野系统起搏及右心室流入道间隔部(RVIS)起搏装置植入手术,比较分析两组术后心脏基本电学参数及短期随访效果。结果两组术中双极起搏阈值、R波感知、阻抗及术前QRS时限、QTc时限比较,差异无统计学意义(均P>0.05)。两组术后QRS时限、QTc时限、LVEF、LVEDD及二尖瓣反流面积缩小比较,差异无统计学意义(均P>0.05)。结论希氏束-浦肯野系统起搏与右心室流入道间隔部起搏技术效果并无显著差异,若考虑到手术操作难度的问题,可酌情优先选择右心室流入道间隔部起搏技术。

Objective To compare the therapeutic effects of His beam-Purkinje system pacing and right ventricular inflow tract septum pacing on the elderly and provide a basis for patient treatment options.Methods From January 2018 to December 2019,70 patients with cardiac pacemaker implantation were randomly divided into His beam-Purkinje system pacing group and the right ventricular septal pacing group,35 cases in each group.They were treated with his bundle Purkinje system pacing and right ventricular inflow septum(RVIS)pacemaker implantation respectively.The basic electrical parameters and short-term follow-up results of the two groups were compared and analyzed.Results There was no significant difference in the threshold of bipolar pacing,R wave perception,impedance,QRS duration and QTc duration between the two groups(all P>0.05).There was no significant difference in QRS duration,QTc duration,LVEF,LVEDd and mitral regurgitation area between the two groups(all P>0.05).Conclusion There is no significant difference between the pacing of the His beam-Purkinje system and the pacing of the right ventricular inflow tract septum.If the difficulty of the operation is considered,the right ventricular inflow septal pacing technology can be selected as a priority.