慢快综合征患者心脏起搏器类型的选择

Selection of Cardiac Pacing for Brady-Techycardia Syndrome

目的 为评价起搏器治疗慢快综合征的疗效 ,积累合并阵发性心房颤动 (房颤 )时起搏器选择的经验。方法 对 35例慢快综合征患者分组进行单腔VVI、AAI和双腔DDD起搏器治疗 ,并在植入起搏器后 1年内进行随访。结果 接受DDD和AAI起搏器的患者 ,房颤的发作情况均大为改善。病人的临床症状 ,如心悸、胸闷、头晕、乏力、气促等 ,在植入AAI和DDD起搏器后半年内全部消失。而植VVI的患者 ,症状虽然有改善 ,但不及另外两组。所有病例在 1年内 ,起搏阈值均无明显的改变及组间差异。结论 对于合并阵发性房颤的病态窦房结综合征 (病窦 )患者 ,应积极选用AAI及DDD起搏器治疗 ,选用AAI起搏器的病例应具备 :①阵发性房颤发作频度每周不超过 2次 ;②持续时间不超过 2h ;③多能自行恢复窦性心律 ;④房颤发作心室率≥ 80次 min。

Objective To determine the criteria selecting cardiac pacemaker model for brady techycardia syndrome and to evaluate its effect to this disease. Methods 35 patients suffering from sick siuns syndrome (SSS) with paroxysmal atrial fibrillation (PAF) were implanted different cardiac pacemakers (VVI,AAI,DDD),and were followed up for 12 months after the operation. Results PAF and the clinical symptoms disappeared in the patients who received AAI or DDD pacemaker during 6 months after operation.There were no,however,such effect in the cases who received VVI pacemakers.The pacing threshold value has no significant change and no different among 3 models of pacemaker. Conclusion Patient with SSS accompanied by PAF should select DDD or AAI pacemaker and the selecting criteria of AAI model are, by our suggestion,as following:①The onset frequency of PAF should be less than 3 times one week.②PAF persisting period is shorter than 2 hours.③All most onset of PAF can return to sinus rhythm spontneously.④The ventricular beat rate should be over 80 beats per minutes while PAF.