螺旋电极右室流出道起搏与右室心尖部起搏血流动力学对比研究

目的:比较右室心尖部起搏(RVAP)与右室流出道起搏(RVOTP)对心输出量的影响。方法:8例患者,5例植入DDDR起搏器,3例植入VVIR起搏器,先将心室电极放在RVA,然后放在RVOT,用Swan-Ganz漂浮导管分别侧定心输出量等血流动力学指标。结果:8例患者全部在RVOT成功植入螺旋电极,RVOT起搏比RVA起搏时的CO、CI明显增加。感知、阈值、阻抗等起搏参数两者无差别。结论:采用螺旋电极行RVOT起搏与传统的RVA起搏相比较,明显改善心输出量。

Comparison of Right Ventricular Outflow Tract Pacing with Right Ventricular Apex Pacing on Hemodynamics Using Screw in Lead

Objective:In order to evaluate hemodynamic benefits of right ventricular outflow tract pacing (RVOTP) compared with right ventricular apex pacing (RVAP).Methods:Of 8 patients (6 male and 2 female mean age 68 years),5 received DDDR pacemaker,3 received VVIR Pacemaker.The ventricular unipolar screw in lead was placed at right ventricular apex first,then at right ventricular outflow tract,the hemodynamics paraneters were measured by Swan Ganz catheter in all patients.Results:The screw in lead was implanted in right ventricular outflow trad successfully in all patients.The cardiac output and cardiac index of RVOTP increased significantly than that of RVAP,while there was no difference in lther pacing parameters between RVOTP and RVAP.Conclusion:RVOTP with screw in lead is safe and can improve the cardiac output significantly compared with conventional RVAP.