心室起搏管理对病态窦房结综合征患者生活质量的影响

目的探讨心室起搏管理（MVP）对病态窦房结综合征（SSS）患者生活质量的影响。方法在15例植入具有MVP功能的双腔起搏器SSS患者中，先以传统频率应答双腔起搏（DDDR）模式工作1个月，再程控为MVP模式工作1个月，分析不同起搏模式下患者累计心室起搏百分比（CumVP％）、4种起搏和感知状态时间百分比的变化，采用明尼苏达心力衰竭生活质量评分表（LiHFe）评估患者在两种不同起搏模式下生活质量的变化。结果随访期间，患者CumVP％由DDDR模式下的91．3％下降至MVP模式下的1．6％（U=130．5，P〈0．01）；4种起搏和感知状态时间百分比比较差异均有统计学意义（P〈0．01）；患者LiHFe总分在DDDR模式下（34．0±3．4）分，MVP模式下（10．4±4．2）分，差异有统计学意义（t=49．4，P〈0．01），其他各项评分比较差异均有统计学意义（P〈0．01）。结论对植入心脏起搏器的SSS患者，MVP不仅是一种安全、有效和可靠的起搏模式，还可以提高患者的生活质量。

Effect of managed ventricular pacing on the life quality of SSS patients with pacemakers

Objective To study the effect of managed ventricular pacing （MVP） on the life quality of SSS patients with pacemakers. Methods Pacemakers with MVP algorithm were implanted in 15 patients. Conventional mode of DDDR was programmed in the first month post operation, and then MVP algorithm was programmed in the second month. Variation of the percentage of the accumulated ventricle pacing （ CnmVP% ） , change of four kinds of pacing and perception state time percentage were analyzed respectively in DDDR and MVP. The quality of the life were tested by the quality of life questionnaire of Minnesota in heart failure subjects （LiHFe） in two monthes. Results During following-up, CumVP% of the MVP algorithm was 1.6% lower than 91.3% of DDDR algorithm, and the difference of four kinds of pacing and perception state time percentage was statistically significant （ U = 130.5 ,P 〈0. 01 ）. In MVP algorithm the LiHFe total score （ 10.4 ±4.2） was significantly lower than that in the conventional DDDR algorithm （ 34. 0 ± 3.4 ） （ t = 49. 4, P 〈 0. 01 ） ; the difference of other dimensions score in DDDR and MVP was statistically significant （P 〈 0. 01 ）. Conclusions MVP algorithm for SSS patients implanted with cardiac pacemaker is a safe, effective and reliable intervention, which can improve their quality of life.