右室流出道间隔部起搏和右心室心尖部起搏对心电图QRS宽度影响的比较

目的观察缓慢型心律失常伴心功能不全的患者行右室流出道(right ventricular outflow trace,RVOT)间隔部起搏和右心室心尖部(right ventricular apex,RVA)起搏对起搏参数与QRS波宽度的影响。方法将80例缓慢型心律失常伴心功能不全的患者随机分RVOT间隔部起搏和RVA起搏两组,分析两组起搏参数、标Ⅱ导联QRS宽度。结果 RVA组起搏术后3个月心电图QRS波宽度为(173.80±5.42)ms,RVOT组为(118.35±3.05)ms,差异有统计学意义(P<0.05);两组起搏阈值、电极阻抗、心室起搏比率在术后即刻和术后3个月进行比较,差异均无统计学意义(P>0.05)。结论与RVA起搏相比,RVOT起搏能保证左心室与右心室正常的激动顺序,对心脏收缩功能的影响小,是一种较为理想的起搏部位。

Influence in electrocardiographic QRS width between right ventricular outflow trace pacing and right ventricular apex pacing

Objective To observe differences of pacing parameters, QRS wave in patients with the slow arrhythmia and cardiac dysfunction between right ventricular apex pacing and right ventricular outflow trace pacing. Methods A total of 80 ca- ses of slow arrhythmia patients with heart failure were randomly divided into two groups, one group of patients with right ven- tricular outflow trace pacing, the other group with traditional right ventricular apex pacing. Two group of pacing parameters, standard II QRS width were analyzed. Results Electrocardiogram QRS width of the group of RVA （173.80±5.42） ms was significantly longer than the group of RVOT （118.35±3.05） ms, had the difference of statistics （P〈0.05）. Two groups of pacing threshold, the electrode impedance, ventricular pacing ratio had no significant statistical differences between after opera- tion and 3 month later （see chart 3）. Conclusion Compared with RVA, RVOT pacing can ensure ventricular normal excite ment, and has less effects on left ventricular contraction function. It is an ideal pacing position.