心房颤动患者右心室不同频率起搏对生活质量及心脏功能的影响

目的 探讨心房颤动患者右心室不同频率起搏对生活质量的影响.方法 以植入永久心脏起搏器前的自身平均心率(AHR)调节起搏频率,分别以(AHR-10)bpm、(AHR-5)bpm、(AHR)bpm、(AHR+5)bpm、(AHR+10)bpm起搏1个月,测量起搏前后的生活质量及6min步行距离.结果 以(AHR+5)bpm起搏时生活质量明尼苏达州心力衰竭生活质量问卷调查分数(innestota living with heart questionnaire,MLHFQ)明显低于以(AHR-10)bpm、(AHR-5)bpm、(AHR)bpm、(AHR+10)bpm起搏时[MLHFQ总评分(36.0±14.59)分,(42.0±15.48)分,(41.1±14.69)分,(38.3±14.48)分,(39.1±14.75)分,身体领域评分(22.5±6.22)分,(26.8±7.24)分,(26.2±6.31)分,(25.3±5.20)分,(25.7±7.15)分,情绪领域评分(13.0±3.62)分,(17.6±4.35)分,(16.8±5.16)分,(16.1±4.19)分,(15.2±4.17)分,均P<0.05],6min步行距离高于以(AHR-10)bpm、(AHR-5)bpm、(AHR)bpm、(AHR+10)bpm起搏时[(454.1±43.45)m,(420.2±46.05)m,(428.3±44.67)m,(428.3±44.67)m,(434.7±42.87)m,(429.5±44.51)m,均P<0.05].结论 心房颤动患者行VVI起搏后,以(AHR+5)bpm起搏,可明显改善患者的生活质量和心脏功能.

Influence of pacing rate in right ventricle on quality of life and heart function in patients with atrial fibrillation

Objective To explore the influence of different pacing rate in risht ventricle on quality of life.Methods Pacing rate was based on the average heart rate(AHR)obtained before implanting pacemaker.Minnestota living with heart failure questionnaire(MLHFQ)and 6 minutes walk test(6MWT)were performed before implanting pacemaker and afer pacing by(AHR-10)bpm,(AHR-5)bpm,(AHR)bpm,(AHR+5)bpm,(AHR+10)bpm respectively one month.Results The total score of MLHFQ,the Score of physical dimentions,the score of emotion dimensions was lower than pacing with rate of(AHR-10)bpm,(AHR-5)bpm,(AHR)bpm,(AHR+10)bpm(36.0±14.59 vs 42.0±15.48,41.1±14.69,38.3±14.48,39.1±14.75,22.5±6.22 VS 26.8±7.24,26.2±6.31,25.3±5.20,25.7±7.15,13.0±3.62 VS 17.6±4.35,16.8±5.16,16.1±4.19,15.2±4.17,P＜0.05,respectively),the distance of6 minutes walk test(6MWT)was higher than pacing with rate of (AHR-10)bpm,(AHR-5)bpm,(AHR)bpm,(AHR+10)bpm[(454.1±43.45)m VS(420.2±46.05)m,(428.3±44.67)m,(428.3±44.67)m,(434.7±42.87)m,(429.5±44.51)m,P＜0.05,respectively]at the pacing rate of(AHR+5)bpm.Conclusion Patients with atrial fibrillation after VVI pacing not only have a better quality of life but also have a better heart function at the pacing rate of(AHR+5)bpm.