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目的比较并评价右心室心尖部起搏与右心室流出道起搏对左心功能以及血流动力学的影响。方法植入双腔心脏起搏器(DDD)患者58例,分为心功能Ⅲ级组25例,其中13例右心室电极位于右室心尖部,12例右心室电极位于右心室流出道;心功能Ⅰ～Ⅱ级组33例,19例右心室电极位于右心室心尖部,14例右心室电极位于右心室流出道。分别比较两组以及各亚组术后3个月心功能各指标以及心电图、血流动力学差异。结果术后组间比较,右心室流出道起搏组左心室射血分数(LVEF),心输出量(CO),每搏量(SV),QRS时限,B型钠尿肽(BNP),二尖瓣口反流面积较右心室心尖部起搏组差异具有统计学意义(P<0.05)。结论右心室流出道起搏优于右心室心尖部起搏。
Objective To compare and evaluate the effects of right ventricular apical pacing and right ventricular outflow tract pacing on left ventricular function and hemodynamics. Methods Fifty-eight patients with dual-chamber pacemaker (DDD) implantation were divided into three groups (n = 25). Thirteen of them were located in the apical part of the right ventricle and 12 in the right ventricular outflow tract. There were 33 cases in functional group Ⅰ ~ Ⅱ, 19 cases of right ventricular electrode in the apical part of right ventricle and 14 cases of right ventricular electrode in right ventricular outflow tract. The indexes of cardiac function, electrocardiogram (ECG) and hemodynamics were compared between the two groups and 3 months after operation respectively. Results Compared between the two groups, the left ventricular ejection fraction (LVEF), cardiac output (SV), stroke volume (SV), QRS duration, BNP, There was a significant difference in the area of valvular regurgitation compared with right atrial apical pacing group (P <0.05). Conclusion Right ventricular outflow tract pacing is superior to right ventricular apical pacing.