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目的:探讨生理性起搏的临床应用。方法:37例病态窦房结综合征(SSS)患者安置AAI型起搏器;46例心律失常患者和15例肥厚型梗阻性心肌病(HOCM)患者安置DDD型起搏器。所有患者均进行随访,并对HOCM患者进行血液动力学观察。结果:经3个月至6年随访,所有心律失常患者临床症状均显著改善,37例AAI起搏患者无1例发生房室传导阻滞;15例HOCM患者左室流出道增宽,压力阶差减低,使流出道梗阻得到不同程度的缓解。结论:AAI及DDD起搏可提供房室顺序起搏。对药物治疗无效的HOCM患者DDD起搏为一种能替代外科手术、安全有效的治疗方法;对病态窦房结综合征患者AAI起搏器为实用、经济、简单的生理性起搏。
Objective: To investigate the clinical application of physiological pacing. Methods: 37 patients with sick sinus syndrome (SSS) were housed with AAI pacemaker. DDD pacemakers were placed in 46 patients with arrhythmia and 15 patients with hypertrophic obstructive cardiomyopathy (HOCM). All patients were followed up, and HOCM patients were observed hemodynamics. Results: After 3 months to 6 years of follow-up, clinical symptoms of all patients with arrhythmia were significantly improved. None of the 37 patients with AAI pacing had AV block. In 15 patients with HOCM, the left ventricular outflow tract was widened, Poor reduction, so that outflow tract obstruction to varying degrees of relief. Conclusion: AAI and DDD pacing can provide atrioventricular pacing. DDD pacing in patients with HOCM that is ineffective for medical treatment is a safe and effective alternative to surgical procedures and practical, economical and simple physiological pacing for AAI pacemakers in patients with sick sinus syndrome.