不同房室间期对双腔起搏左室收缩功能的影响

为探讨双腔起搏不同房室间期对左室收缩功能的影响及最佳房室间期 ,选择 18例置入DDD起搏器的病窦综合征患者 ,在DOO起搏方式下随机将房室 (AV)间期程控为 10 0 ,130 ,15 0 ,170 ,2 0 0ms,在超声心动图下观察左室收缩功能指标 ,每次测量间隔 5min以上。结果 :AV间期为 15 0ms时左室收缩功能最好 ,与AV间期为 10 0ms时相比 ,左室收缩功能明显改善。以心输出量 (CO)为标准 ,18例中有 9例AV间期在 15 0ms时CO最佳 ,5例在 2 0 0ms时CO最佳 ,3例在 170ms时CO最佳 ,1例在 130ms时CO最佳 ;以CO为标准 ,DOO起搏方式最佳AV间期为 16 6±2 4ms。结论 :双腔起搏的AV间期对左室收缩功能有重要的影响 ,以CO为标准 ,个体化地选择双腔起搏的最佳AV间期对改善患者的心脏功能有重要的意义。

The Effects of Different Atrioventricular Delays on Left Ventricular Systolic Function in Patients With Dual-chamber Pacemakers

Comparing the effects of different atrioventricular delays(AVDs) of DOO on left ventricular function by studying the patients with dual chamber pacemakers.18 patients with dual chamber pacemakers were included in the study.DOO pacing mode was programmed in random order to 5 different AVDs:100,130,150,170 ,200 ms.Applying echocardiography to measure left ventricular systolic function targets.A period of 5 minutes was allowed for each measurement.The best left ventricular systolic function would be got at 150 ms.Comparing with 100 ms,left ventricular systolic function was improved significantly at 150 ms.In these 18 patients,the optimal cardiac output(CO) was got of 9 cases at 150 ms,5 at 200 ms,3 at 170 ms,1 at 130 ms.According to CO,the optimal AVD was 166±24 ms.Conclusion:Left ventricular systolic function was effected greatly by AVDs of dual chamber pacing.It would ameliorate the patients′ left ventricular function by individually selected the optimal AVD of dual chamber pacing.