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目的观察心脏再同步化治疗(CRT)时最佳AV间期值变化规律及其对心脏电同步性和血流动力学的影响。方法13例行CRT的患者,术中尽可能让左右室电极导管的距离最远。术后在超声下获取最佳AV间期,并记录EF和12导体表心电图。结果不同个体的最佳AV值从110~230ms,有较大离散度,合并房间阻滞者最佳AV间期值均较大;同一个体的最佳AV值因随访时间不同而变化;心房激动能经房室结下传者其心电图QRS时限随AV间期变化而改变,同时伴有血流动力学变化。结论最佳AV间期值有较大的个体差异性并随时间而变化,房间阻滞者常有较长的最佳AV间期值;激动能经房室结下传者,适宜的AV值能进一步改善心室同步性。
Objective To observe the changes of the best AV interval value during cardiac resynchronization therapy (CRT) and its influence on cardiac electrical synchronization and hemodynamics. Method 13 cases of CRT patients, intraoperative as far as possible to the left and right ventricular catheter distance. The best AV interval was obtained under ultrasound and EF and 12-conductor ECG were recorded. Results The best AV values of different individuals ranged from 110 to 230 ms with greater dispersion and the best AV interval values in patients with block were larger. The best AV value of the same individual varied with the follow-up time. Atrial activation The ECG QRS duration can be changed by the AV interval, accompanied by hemodynamic changes. Conclusion The best AV interval value has larger individual differences and changes with time, the room blockers often have longer the best AV interval value; excited by the AV node, the appropriate AV value Can further improve ventricular synchrony.