永久性心脏起搏器植入对左心室重构影响研究

目的:分析心脏起搏器植入后不同起搏方式对左心室重构的影响。方法:共入选34例患者,其中VVI起搏器20例,DDD起搏器14例,分别在术前及术后5~12个月,用超声心动图观测左室舒张末期内径、左室收缩末期内径、左室射血分数。结果:34例起搏器植入患者均出现左心室重构,VVI组观测指标植入前后比较差异有统计学意义,DDD组观测指标差异无统计学意义。结论:起搏器植入后均可出现左心室重构,提示右室心尖部起搏对左心室的收缩、舒张功能产生不利影响;起搏器植入应选用生理性或接近生理性起搏方式。

Structural remodeling of left ventricle after pacemaker implantation

Objective To assess the characteristics of structural remodeling of left ventricle after pacemaker implantation by Doppler echocardiogram.Methods The left ventricular diastolic dimension,left ventricular systolic dimension,left ventricular ejection fraction were collected by Doppler echocardiogram before pacemaker implantation and in 5 to 12 months after implatation in 34 patients.VVI pacemaker was implanted in 20 patients,and DDD pacemaker was impanted in 14 patients.Results Some parameters,such as left ventricular diastolic dimension,left ventricular systolic dimension,and left ventricular ejection fraction in patients receiving VVI pacemaker implantation had statistic difference and DDD pacemaker had no statistic difference after implantation.Conclusion The structural remodeling of left ventricle happens after the pacemaker implantation,especially in right ventricular apex pacing.It is suggested that the DDD pacemaker may bring more benefits after implantation than the VVI pacemaker on the change of structure and function of left ventricle.