右室心尖部与间隔部起搏对心功能影响的临床分析

目的:探讨右室流出道室间隔起搏与右室心尖部起搏对心功能的影响。方法:选择在本院安装永久性人工心脏起搏器并随访资料完整的患者,分为两组,右室心尖部起搏组(RVA)29例,右室流出道间隔部起搏组(RVOT)40例,于术前、术后6个月、术后12个月做心脏超声检查,测定患者左室射血分数(EF)、左室收缩末期容积(ESV)、左室舒张末期容积(EDV),并检测血浆中脑钠肽N末端前体(NT-proBNP)水平的变化。对比右室流出道室间隔起搏组和右室心尖部起搏组两组患者心脏超声和NT-proBNP的动态变化。结果:到12个月随访时,RVA组病例EDV明显大于术前(P?0.05),EF明显小于术前(P?0.05),血浆NT-proBNP值明显大于术前(P?0.01);RVOT组EF值大于RVA组(P?0.05),血浆NT-proBNP值小于RVA组(P?0.01)。结论:右室流出道间隔部起搏对心功能影响较小。

Comparison of septal and apical Right ventricular pacing with on cardiac Function

Objective:To compare the septal right ventricular outflow tract pacing with right ventricular apical pacing on cardiac function.Methods:In our hospital to install a permanent artificial cardiac pacemaker and a complete follow-up data were divided into two groups,right ventricular apical pacing(RVA)29cases,right ventricular septal pacing group(RVOT)40patients before surgery,after 6 months,and 12months after a heart ultrasound to measure left ventricular ejection fraction(EF),left ventricular end systolic volume(ESV),left ventricular end-diastolic volume(EDV)and detection of plasma N-terminal pro brain natriuretic peptide(NT-proBNP)levels of body changes.Comparison of right ventricular outflow tract ventricular septal pacing group and right ventricular apical pacing echocardio-graphy and patients were dynamic changes of NT-proBNP.Results:The follow-up to 12months,RVA group of patients left ventricular end diastolic volume(EDV)was significantly greater than that in admission,EF was significantly less than that in admission,plasma NT-proB-NP was significantly greater than the admission;left ventricular ejection fraction(EF)in RVOT group were singnificant larger than that in the RVA group,plasma NT-proBNP less than the that in RVA group.Conclusion:Right ventricular outflow tract septal pacing on cardiac function is less affected.