DDD起搏对病窦综合征患者阵发性心房颤动的远期影响

为观察DDD起搏对病窦综合征 (SSS)患者阵发性心房颤动 (AF)的远期影响 ,对 6 6例合并阵发性AF的病窦综合征患者 ,择期置入DDD永久起搏器 ,术后进行临床、心电图、2 4h动态心电图的定期随访 ,观察比较DDD起搏器置入术前 1年、术后 1,2 ,5年的阵发性AF发作频率以及发作持续时间。结果 :所有患者起搏器置入后随访 1～ 2年阵发性AF发作的频率及发作的时间较起搏器置入前显著减少 (T0 -1146 ,T0 -2 137,P均 <0 .0 5 ) ;术后随访 5年时阵发性AF发作的频率及发作的时间较术后 1～ 2年显著增加 (T1-5143,T2 -512 1,P均 <0 .0 5 )。所有患者术后无心力衰竭、血栓栓塞发生。结论 :DDD起搏对SSS并发的阵发性AF的发生有抑制及预防作用 ,这种影响在起搏器治疗近中期最为显著 ,远期疗效不肯定尚需进一步临床观察。

The Long-Term Effect of DDD Pacing on Prevention of Paroxysmal Atrial Fibrillation in Patients With Sick Sinus Syndrome.

The Long-Term effect of DDD pacing on the prevention of paroxysmal atrial fibrillation(AF) in patients with sick sinus syndrome(SSS),66 patients with SSS planted DDD pacemaker were regular follow-up to compare the changes of the frequency and lasting time of AF by symptom,ECG,and Holter.Results:The frequency and lasting time of paroxysmal AF in patients with SSS were significantly less than those before planted DDD pacemaker(T 0-1 146,T 0-2 137,all P<0.05) in follow-up 2 years.The frequency and lasting time in follow-up 5 years were obviously increased than those in follow-up 2 years(T 1-5 143,T 2-5 121,all P<0.05).Heart failure and thrombo-embolism didn′t occur in all of the patients.Conclusions:DDD pacing can prevent and inhibit paroxysmal AF.This influence is most significant in metaphase,but long-term effect couldn't confirm and should take clinical observation.