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目的:观察右心室高位室间隔起搏和心尖部起搏对心功能和左室重构的影响。方法:40例患者分别行右心室高位室间隔部起搏及右心室心尖部起搏治疗,于术前1d、术后6个月行常规心电图,超声心动图,24h动态心电图,血浆脑钠肽(BNP)检查。结果:与右心室心尖部起搏比较,右心室高位室间隔起搏QRS波时限增宽程度小,左心室射血分数(LVEF)及每搏出量(SV)降低程度小,左心室舒张末期内径(LVEDD)和BNP增加程度小。结论:右心室高位室间隔起搏与右心室心尖部起搏比较,对心室重构及心功能的不利影响较小,更接近生理性起搏,使血流动力学更接近生理状态,是更佳的起搏部位。
Objective: To observe the effects of right ventricular septal pacing and apical pacing on cardiac function and left ventricular remodeling. Methods: Forty patients underwent right ventricular superior ventricular septal pacing and right ventricular apical pacing. The patients were given routine electrocardiogram, echocardiography, 24h electrocardiogram and plasma brain natriuretic peptide at 1 day before operation and 6 months after operation. (BNP) examination. Results: Compared with right ventricular apical pacing, the duration of QRS wave of right ventricular superior ventricular septal pacing was less and the left ventricular ejection fraction (LVEF) and stroke volume (SV) Internal diameter (LVEDD) and BNP increase is small. Conclusion: Compared with right ventricular apical pacing, right ventricular superior ventricular septal pacing has less adverse effects on ventricular remodeling and cardiac function, is more close to physiological pacing, and makes hemodynamics closer to physiological status. Good pacing site.