右室流出道间隔部与心尖部起搏血液动力学临床对比研究

目的比较右室流出道（RVOT）间隔部起搏和右室心尖部（RVA）起搏对血液动力学的影响。方法38例病窦或Ⅱ°AVB、Ⅲ°AVB行RVOT间隔部埋藏式起搏术患者，26例DDD起搏，12例VVI起搏，用二维超声心动图测定上述患者术后7～10d的血液动力学参数，并与54例行RVA埋藏式起搏术患者（其中42例DDD起搏，12例VVI起搏）进行对比；同时对上述2组患者行RQS间期（QRSd）测试及6min步行试验（6MWT）的结果进行对比。结果RVOT间隔部起搏比RVA起搏、每分输出量（CO）、心脏指数（CI）、左室射血分数（EF）、左室充盈时间（LVFT）、6MWT均有明显的提高，QRSd有显著的减少。结论RVOT间隔部起搏比RVA起搏能获得更好的血液动力学效应。

A clinical comparison of hemodynamics between RVOT septum pacing and RVA pacing

Objective To study the pacing effect at RVOT septum and RVA on hemodynamics. Methods Among 38 sick sinus or sufferers undergoing implanted pacing at RVOT septum for Ⅱ°AVB or Ⅲ°AVB, 26 received DDD pacing while the other 12 received VVI pacing. The sufferers＇indexes 7 - 10 days after the operation were tested with 2D echoeardiography and compared with 54 cases who underwent RVA implanted pacing, of whom 42 received DDD pacing and 12 VVI pacing. At the same time, the results of the two groups＇ QRSd interval and 6MWT were also compared. Results RVOT septum pacing, compared with RVA pacing, showed obvious improvement as regards cardiac output （CO ）, cardiac index （CI ）, left ventricular ejection fraction （EF） , left ventricular filling time （LVFT） and 6MWT. There was also remarkable decrease in QRSd. Conclusion RVOT septum pacing can be more effective in hemodynamics than RVA pacing.