不同起搏方式及右室起搏比例不同对缓慢型心律失常患者心功能及新发房颤影响的随访分析

目的：探讨不同起搏方式及右室起搏比例不同对缓慢型心律失常患者新发房颤（atrial fibrillation，AF）及心功能的影响。方法我院心内科过去5年间植入永久起搏器的患者，按照起搏模式不同分为VVI、DDD组，根据右室起搏比例（Cum％VP）不同分为：DDD1组（Cum％VP≥50％）和DDD2组（Cum％VP＜50％）两个亚组。随访内容包括起搏器植入术前、术后3年心电图和动态心电图，AF发生情况，超声心动图参数。结果符合入选标准且完成随访的患者共计147例，新发AF病例VVI组14例（24．14％），DDD1组5例（11．11％），DDD2组3例（6．82％）。DDD2组与VVI组比较，差异有统计学意义（P＝0．03＜0．05）。术后3年超声参数比较，DDD2组与VVI组、DDD1组相比，LAD、LVED明显缩小，LVEF则明显升高，差异有统计学意义（P＜0．05）。结论DDD起搏模式加低右室起搏比例与VVI模式相比，可明显改善患者的心功能，且减少AF的发生，DDD起搏模式加最优右室起搏管理应用于临床可能给患者带来更多的收益。

Follow-up analysis of different pacing and right ventricular pacing with different proportion of impact on ;cardiac function and new onset arterial fibrillation in patients with slow arrhythmia

Objective To explore the effect of different pacing and right ventricular pacing with different proportion on the cardiac function and new onset atrial fibrillation in patients with slow arrhythmia .Methods Department of Cardiology in our hospital over the past 5 years, implantation of a permanent pacemaker patients , in accordance with the pacing mode is divided into VVI , DDD groups, the right ventricular pacing （Cum%VP） in different proportion：DDD1 group （ Cum%VP≥50%） and group DDD2 （ Cum%VP 〈50%） two subgroups . Follow up includes before pacemaker implantation , after 3 years of electrocardiogram and dynamic electrocardiogram , situation of atrial fibrillation , ultrasonic Heartbeat diagram parameters . Results The inclusion criteria were a total of 147 patients , new onset atrial fibrillation patients in group VVI were 14 cases （24.14%）, DDD1 group of 5 cases （11.11%）, DDD2 group of 3 cases （6.82%）.DDD2 group compared with VVI group, the difference was statistically significant （P=0.03〈0.05）.Comparison of 3 years ultrasound parameters after operation, DDD2 group compared with VVI group and DDD1 group, LAD,LVED significantly decreased, while LVEF increased, the difference was statistically significant （ P 〈0.05）.Conclusions Compared with the proportion of VVI mode , DDD pacing mode of low right ventricular pacing can improve heart function of patients , and reduce the incidence of AF , pacemaker management application of DDD pacing mode and optimal right ventricular in clinic may bring more benefits to patients .