40例VVI起搏器植入患者右心室心尖起搏和右心室流出道起搏的临床对比研究

目的 探讨植入VVI起搏器患者，相对于右心室心尖部起搏（RVA），右心室流出道间隔部起搏（RVOT）是否改善心功能。方法 入选首都医科大学附属复兴医院2015年2月~2016年7月，植入单腔（VVI）起搏器患者40例，随机分为RVA和RVOT两组，随访观察半年，对两组患者起搏参数、心功能等进行对比分析。结果 两组均顺利完成手术，无手术并发症发生。手术即刻起搏阈值RVOT组与RVA组比较，差异有统计学意义（P<0.05）；术后半年两组起搏阈值差异无统计学意义。RVA组左心室射血分数（LVEF）术后半年较术前比较，差异有统计学意义（P<0.05）。两组间比较，差异无统计学意义（P>0.05），但RVA组有下降趋势。结论 针对VVI起搏患者建议尽量将心室起搏电极放置在RVOT间隔部，可能改善心功能。

Comparison of Effects on 40 Patients with VVI Pacemaker Between Right Ventricular Apical Pacing and Right Ventricular Outflow Tract Pacing

Objective To evaluate,right ventricular apex pacing(RVA)compared with right ventficular outflow tract pacing(RVOT)which can improve heart function in the implanted VVI pacemaker patients. Methods The 40 patients with VVI pacemakers implantion from February 2015 to July 2016 in Fuxing Hospital were reviewed, and randomly divided into RVA and RVOT two groups,followed up for 6 months. The pacing parameters and cardiac function were compared between the two groups. Results Two groups were successfully completed,and no complications occurred. Compared with the RVA group, there was statistical significance in Immediate pacing threshold,P<0.05.There was no statistical difference in pacing threshold six months later. Compared with preoperative,RVA group postoperative LVEF was statistical difference (P<0.05). There was no significant difference between the two groups, but the RVA group had a downward trend. Conclusion Patients with VVI pacemaker with ventricular pacing is recommended to the electrode placed in the RVOT interval, may improve cardiac function.