摘要
目的分析右心室间隔部、心尖部起搏对植入永久起搏器患者双心室同步性的影响。方法回顾性选取阜阳市人民医院2020年6月~2021年12月80例植入永久起搏器患者,根据心室电极位置的不同分组,将38例右心室心尖部(RVA)起搏患者作为对照组,将42例右心室间隔部(RVS)起搏患者作为观察组,对比两组QRS波宽度、双心室同步性指标、流动力学参数、不良事件总发生率、全因病死率。结果术后1个月,观察组QRS波宽度低于对照组;心室间机械运动延迟(IVMD)、室间隔与左心室后壁之间的运动延迟(SPWMD)低于对照组,左室射血分数(LVEF)高于对照组,差异均具有统计学意义(P<0.05)。观察组左心室舒张末期内径(LVEDD)、心肌做功指数(Tei)低于对照组,A峰最大充盈速度比值(E∕A)、心输出量(CO)、每搏输出量(SV)高于对照组,差异均具有统计学意义(P<0.05)。术后6个月,观察组不良事件总发生率、全因病死率与对照组比较,差异均无统计学意义(P>0.05)。结论与RVA相比,RVS与生理性起搏更为接近,可有效维持双心室同步性,减轻心功能受损程度,且不良事件总发生率较低。
Objective To analyze the effect of right ventricular septal and apical pacing on biventricular synchrony in patients with permanent pacemaker implantation.Methods A retrospective study was performed on 80 patients with permanent pacemaker implantation in our hospital from June 2020 to December 2021.According to the different groups of ventricular electrode positions,38 patients with right ventricular apex(RVA)pacing were selected as the control group.42 patients with right ventricular septal(RVS)pacing were selected as the research group,and the QRS wave width,biventricular synchrony index,hemodynamic parameters,total incidence of adverse events,and all-cause mortality were compared between the two groups.Results The QRS wave width of the control group was higher than that of the study group at 1 month after surgery,significance,the IVMD and SPWMD of the control group at 1 month after surgery were higher than those of the study group,and the LVEF of the control group at 1 month after surgery was lower than that of the study group,significance(P<0.05).The LVEDD and Tei of the control group were higher than those of the study group at 1 month after operation,and the E∕A,CO,and SV of the control group were lower than those of the study group at 1 month after operation,significance(P<0.05).6 months after operation,the total incidence of adverse events and all-cause mortality in the control group were compared with those in the control group(P>0.05).Conclusion Compared with RVA,RVS is closer to physiological pacing,can effectively maintain biventricular synchrony,reduce the degree of cardiac function impairment,and has a lower overall incidence of adverse events.
作者
郭英杰
宁彬
王园园
葛慧娟
李文俊
Guo Yingjie;Ning Bin;Wang Yuanyuan(Department of Cardiovascular Medicine,People′s Hospital of Fuyang,Fuyang 236000,China)
出处
《中华保健医学杂志》
2023年第4期384-386,共3页
Chinese Journal of Health Care and Medicine
基金
蚌埠医学院自然科学类项目(2020byzd345)。
关键词
右心室
间隔部
心尖部
永久起搏器
双心室同步性
Right ventricle
Septum
Apex
Permanent pacemaker
Biventricular synchrony
