房室间期自动搜索功能对心室起搏及心功能的影响

目的 观察自动AV间期搜索功能双腔起搏器减少心室起搏和高频心房事件的效果及对心功能的影响.方法 60例置入DDD/R起搏器的患者（有AV搜索功能30例,无AV搜索功能30例）,术后1年内程控获取右室起搏百分比、高频心房事件,检查超声心动图,测试血浆利钠肽（BNP）值.结果 有AV搜索功能组术后6个月和12个月右室起搏百分比明显小于无AV搜索功能组（21.2±6.0）％比（78.3±7.5）％,（19.1±6.5）％比（73.4±7.9）％,P均＜0.05）.AV搜索功能组左室射血分数、左室Tei指数均明显改善（0.57±0.03比0.53±0.05,0.48±0.15比0.68±0.20,P均＜0.05）;BNP水平明显降低（75.2±34.5）pg/ml）比（37.0±16.4）pg/ml,P＜0.05];高频心房事件也显著减少（42±10）次比（19±11）次,P＜0.05].结论 AV自动搜索功能起搏器可有效减少不必要的右室起搏及高频心房事件,改善血流动力学效应.

The effect of auto AV search algorithm in dual chamber pacemaker on the ventricular pacing and cardiac function

Objective To observe the effect of reducing ventricular pacing and high-frequency atrial events and cardiac function with the auto AV search algorithm. Methods Sixty patients implanted with two types of DDD/R pacemakers （AV Search group 30 cases,non AV Search group 30 cases）were investigated in one year of follow-up study. The percent of right ventricular pacing, high frequency atrial event,plasma brain natriuretic peptide （BNP） level and echocardiograph were recorded. Results Patients implanted with AV Search DDD/R had a significant decrease in percentage of ventricular pacing 6 and 12 months after im- plantation（21.2±6.0）% vs （78.3±7.5）%, （19.1±6.5）% vs （73.4±7.9）%, all P〈0.05. The left ventricular e- jection fraction and left ventricular Tei index were improved in AV Search group （0.57±0.03 vs 0.53± 0.05,0.48＋0.15 vs 0.68±0.20,P〈0.05. The plasma BNP levels were significantly decreased （75.2±34.5）pg/ml vs （37.0±16.4）pg/ml,P〈0.05, and atrial high rate events were also significantly reduced in AV Search group （42±10）times vs （19±11）times,P〈0.05. Conclusion The search AV algorithm in the dual chamber pace- maker effectively reduces unnecessary right ventricular pacing, high-frequency atrial events and improves cardiac function.