抗心房颤动起搏器临床应用的初步结果

来源 :中华心血管病杂志 | 被引量 : 0次 | 上传用户:siyu321
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目的初步评价德国百多力公司生产的PhilosDDDR型起搏器抗心房颤动(房颤)功能的效果。方法38例病态窦房结综合征合并阵发性房颤的患者置入了PhilosDDDR型起搏器,术后打开模式转换功能(AutoModeSwitch,AMS),关闭抗房颤功能。记录1个月AMS次数、心房及心室起搏百分比、心率、房性早搏(房早)次数及临床症状等。之后打开抗房颤功能,并将此功能设置在“中档”,1个月后使用程控仪调出以上数据,并比较开启此功能前后1个月二者的差异。结果与起搏器置入术前比较,不论抗房颤功能开启与否,绝大多数患者头晕、气短、乏力、心悸等症状明显减轻或消失,运动耐受量改善。在打开抗房颤功能后,多数患者诉临床症状与开启此功能前差异无统计学意义,5例(13.2%)患者诉心悸及气短;在使用程控仪将抗房颤功能由“中档”降到“低档”后症状明显减轻。打开抗房颤功能后,房早发生率显著性降低(P<0.05),心房起搏的比率及心率明显增加(P<0.05)。然而,AMS次数无显著性减少(P>0.05),说明房性快速性心律失常无明显减少。结论将PhilosDDDR型起搏器的抗房颤功能设置在“中档或低档”,虽然房早显著性减少,心房起搏比率增加,但房颤或房性心动过速并无显著性降低。 Objective To evaluate the efficacy of PhilosDDDR pacemaker in anti-atrial fibrillation (AF) function produced by German Bio-Power Corporation. Methods Thirty-eight patients with sick sinus syndrome and paroxysmal atrial fibrillation were enrolled in the PhilosDDDR pacemaker. The mode switching function (AutoModeSwitch, AMS) was switched on and the anti-atrial fibrillation function was switched off. Record 1 month AMS number, atrial and ventricular pacing percentage, heart rate, atrial premature beats (Atrial Fibrillation) frequency and clinical symptoms. After opening the anti-atrial fibrillation function, and this feature is set to “mid-range”, a month later using the programmer to bring up the above data, and compare this feature before and after 1 month of the difference between the two. Results Compared with the preoperative pacemaker, whether the anti-atrial fibrillation function was on or not, the majority of patients had obvious dizziness, shortness of breath, fatigue, palpitations and other symptoms were significantly reduced or disappeared, exercise tolerance improved. In the open anti-atrial fibrillation function, the majority of patients v. Clinical symptoms and open this feature before the difference was not statistically significant, 5 patients (13.2%) v. Palpitations and shortness of breath; using program-controlled instrument to anti-atrial fibrillation from “mid-range” After the “low” symptoms significantly reduced. After anti-atrial fibrillation was switched on, the incidence of atrial fibrillation was significantly lower (P <0.05) and atrial pacing rate and heart rate were significantly increased (P <0.05). However, there was no significant reduction in the number of AMS (P> 0.05), indicating no significant reduction in atrial tachyarrhythmia. Conclusion The PhilosDDDR-type pacemaker anti-atrial fibrillation function in the “mid-range or low-grade”, although the room early significantly reduced, atrial pacing rate increased, but no significant reduction in atrial fibrillation or atrial tachycardia.
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