With the widespread application of artificial permanent pacemakers in clinical practice,there have been new changes in the indications for pacemaker implantation.The current clinical indications include high atriovent...With the widespread application of artificial permanent pacemakers in clinical practice,there have been new changes in the indications for pacemaker implantation.The current clinical indications include high atrioventricular block,sick sinus syndrome,cardiac resynchronization therapy for heart failure,and implantation of cardioverter defibrillators for ventricular arrhythmias.The implantation of a pacemaker can improve the quality of life and prognosis of patients with arrhythmia.In the past,permanent pacemaker implantation was performed in clinical practice,and the right ventricular pacing electrode was often fixed at the apex of the right ventricle,which belongs to non physiological pacing.Through long-term clinical follow-up,it was found that apex pacing can easily cause abnormal depolarization of the left ventricle,asynchronous contraction of the myocardium,and ultimately lead to myocardial fibrosis,which has adverse effects on the patient's cardiac function and psychological state.In recent years,Scholars have found that pacing in the right ventricular outflow tract septum is closer to the atrioventricular node and closer to the His bundle Purkinje fibers.The pacing impulse almost simultaneously expands towards both ventricles,closer to the physiological pacing state,thereby reducing the occurrence of cardiovascular events in patients.This article explores the impact of pacing in different parts of the heart on the cardiac function and psychological state of patients based on clinical data from the past three years.展开更多
The right ventricular (RV) apex is the traditional site to provide stable and reliable chronic ventricular pacing. Interest in alternate site pacing has grown since RV apical pacing has been associated with increased ...The right ventricular (RV) apex is the traditional site to provide stable and reliable chronic ventricular pacing. Interest in alternate site pacing has grown since RV apical pacing has been associated with increased mortality and morbidity compared to normal atrio-ventricular conduction. 1-4 Alternate pacing sites include the RV septum and outflow tract.展开更多
文摘With the widespread application of artificial permanent pacemakers in clinical practice,there have been new changes in the indications for pacemaker implantation.The current clinical indications include high atrioventricular block,sick sinus syndrome,cardiac resynchronization therapy for heart failure,and implantation of cardioverter defibrillators for ventricular arrhythmias.The implantation of a pacemaker can improve the quality of life and prognosis of patients with arrhythmia.In the past,permanent pacemaker implantation was performed in clinical practice,and the right ventricular pacing electrode was often fixed at the apex of the right ventricle,which belongs to non physiological pacing.Through long-term clinical follow-up,it was found that apex pacing can easily cause abnormal depolarization of the left ventricle,asynchronous contraction of the myocardium,and ultimately lead to myocardial fibrosis,which has adverse effects on the patient's cardiac function and psychological state.In recent years,Scholars have found that pacing in the right ventricular outflow tract septum is closer to the atrioventricular node and closer to the His bundle Purkinje fibers.The pacing impulse almost simultaneously expands towards both ventricles,closer to the physiological pacing state,thereby reducing the occurrence of cardiovascular events in patients.This article explores the impact of pacing in different parts of the heart on the cardiac function and psychological state of patients based on clinical data from the past three years.
文摘目的:运用超声心动图(ultrasonic cardiogram,UCG)评价右室心尖部(right ventricular apical,RVA)起搏及右室间隔部(right ventricular septal,RVS)起搏对完全性房室传导阻滞患者左室、左房收缩功能的影响,并观察两组患者的血浆脑钠肽(brain natriuretic peptide,BNP)水平的变化,研究植入埋藏式心脏起搏器术后左室收缩功能与血浆BNP之间是否具有相关性。方法:将具备埋藏式心脏起搏器植入适应证的51例完全性房室传导阻滞患者随机分为RVA起搏组(RVA组,20例)和RVS起搏组(RVS组,31例),分别于术前、术后1、3、6及12个月采用二维超声心动图Simpson法测定所有患者的左室射血分数(ejection fraction of left ventricle,LVEF)及左房射血分数(ejection fraction of left atrial,LAEF),同时测定患者血浆BNP值。结果:两组LVEF术后12个月较术前、术后1个月、术后3个月有所恢复(P<0.01);两组LAEF术后6个月、12个月较术前、术后1个月、术后3个月有所恢复(P<0.01);RVS组术后6个月、12个月LAEF恢复程度优于RVA组(P<0.01);RVS组术后12个月LVEF恢复程度优于RVA组(P<0.01)。所有患者LVEF与BNP水平呈负相关(r=-0.51,P<0.05)。RVS组术后BNP水平低于RVA组(P<0.01),RVS组术前、术后BNP水平不同时间点之间有差异(P<0.01)。结论:RVS起搏较RVA起搏更有利于左室及左房射血功能恢复,可能是更为理想的右室起搏部位。血浆BNP水平与LVEF具有相关性,可在一定程度上反映心脏起搏器安置术后患者左室收缩功能的恢复情况。
文摘The right ventricular (RV) apex is the traditional site to provide stable and reliable chronic ventricular pacing. Interest in alternate site pacing has grown since RV apical pacing has been associated with increased mortality and morbidity compared to normal atrio-ventricular conduction. 1-4 Alternate pacing sites include the RV septum and outflow tract.
