右室流出道和右室心尖部起搏对心肌复极离散度的影响

目的:探讨右室流出道(RVOT)和右室心尖部(RVA)起搏时心电图心肌复极标志的变化及不同起搏方式对心肌复极离散度的影响。方法:选取我院因三度房室传导阻滞安装DDD起搏器的患者68例,将心室电极分别置于RVOT或RVA,术前及术后1周观测体表心电图的QRS时限、QTc间期、Tp-ec间期和Tp-e/QT。结果:术后两组QRS时限、QTc、Tp-ec间期及Tp-e/QT比值较术前均延长,且RVA组较RVOT组延长显著(P<0.05)。结论:与RVA起搏比较,RVOT起搏对心电同步性及心肌复极离散度、跨壁复极离散度(TDR)影响较小。

Effect of right ventricular outflow tract and apical pacing on myocardial dispersion of repolarization

Objective：This study is aimed to observe the effect of right ventricular outflow tract （RVOT） and right ventricular apical（RVA） pacing on the dispersion of myocardial repolarization .Methods ：68 patients with complete atrioventricular block were selected ,who were implanted with DDD pacemakers .They were divided into RVOT pacing group（n= 34） or RVA pacing group （n=34） .Standard surface ECGs were recorded before and after the operation to implant the pacemaker .The parameters of repolarization dispersion included QRS duration ,QTc in-terval ,Tp-ec interval ,and Tp-e/QT ratio .Results：Post-operation QRS duration ,QTc interval ,Tp-ec interval and Tp-e/QT ratio were all prolonged in the both group ;these parameters were significantly longer in the RVA group than the RVOT group （P ＆lt;0 .05） .Conclusion：Compared with RVA pacing ,RVOT pacing shows benefit effect in e-lectrical synchronization ,myocardial dispersion of repolarization and transmural dispersion of repolarization .