DDD起搏治疗缓慢型心律失常的临床分析

The Clinical Analysis of The Treatment with DDD Pacing in Patients with Bradyarrhythmia

目的 探讨DDD起搏在缓慢型心律失常中的临床疗效与安全性。方法 4年中28例缓慢型心律失常的住院患者,均安装DDD型心脏永久性起搏器。结果 28例患者均手术成功,术中测得心室起搏阈值(0.45±0.19)V,阻抗(714±168)ohm,R波振幅(13.5±4.0)mV,右心房起搏阈值为(0.71±0.25)V,阻抗(687±192)ohm,P波振幅(4.5±1.7)mV。A-V间期程控在120～200 ms之间,下限频率程控为60～70 bpm,上限频率程控于100～130 bpm之间。随访3～46个月,所有患者的生活质量明显改善(P<0.05),无起搏器并发症发生。结论 生理性起搏(包括DDD起搏)可获得接近于正常的的血液动力学效应,改善心功能。对有适应症的起搏器患者应首先推荐使用生理性起搏器,如DDD型。

Objective To evaluate both the clinical efficacy and savety of the treatment with DDD pacing in brad-yarrhythmia. Methods 28 patients were treated with DDD pacemaker, which were treated in the department of cardiolo-gy in nearly four years. Results The pacing threshold of right ventricular leads were 0.45 ± 0.19 V, the resistance were 714 ± 168 ohm and the amplitude of R wave were 13.5 ± 4.0 mV. The pacing threshold of right atrial leads were 0.71 ± 0.25 V,the resistance were 687 ± 192 ohm, the amplitude of P wave were 4. 5 ± 1.7 mV. The AV intervals of dual chamber pacemakers were programmed between 120 ～ 200 ms. There were no complications in the follow-up of 3-46 months. The quality of lives was improved significantly(P<0. 05). Conclusion Physiological Pacing (including DDD pacing) may get the almost normal hemodynamic effects and can also amend the heart function. So it can be applied pri-marily to patients with bradyarrhythmias,such as DDD pacemaker.