应用三维超声心动图评价三种不同起搏方式对左心功能的影响

应用三维超声心动图（３－ＤＥ）测定８例植入双腔起搏器病人心室功能参数，观察按需型起搏（ＶＶＩ）、房室顺序型起搏（ＤＶＩ）、心房按需型起搏（ＡＡＩ）三种不同起搏方式对左心功能及左室壁活动的影响。结果发现：ＡＡＩ起搏较ＤＶＩ、ＶＶＩ起搏的每搏量分别增加１３．６％，３５．２％（Ｐ＜０．０１）。ＡＡＩ与ＶＶＩ比较左室壁节段收缩率弱的面积减少，节段收缩率强的面积增加。认为ＡＡＩ起搏既保持了房室顺序同步性又维持了心室收缩舒张顺序的同步性，是较理想的起搏方式。３－ＤＥ是研究心脏起搏血液动力学变化的一种无创伤及更为准确可靠的手段。

Evaluation of Three Different Pacing Moulds on Left Ventricle Function by Three-Dimensional Echocardiography

Three-Dimensional echocardiography( 3-DE )was used to elvaluate the left ventricle cardiac function and left ventricular wall motion during the three different pacing moulds(VVI,DVI,AAI)in 8 patients implanted DDD pacemaker.The results showed that(1)stroke volum and left ventricular ejection fraction during AAI were significantly more than those during DVI and VVI(P<0. 001),(2)myocardium area of high segment contraction rate was increased during AAI.These suggested that AAI had atrioventricular synchrony and synchrony of ventricle contraction,and was a suitable pacing mould.3-DE may be a noninvasive and accurate way to evaluate the hemodynamic changes of cardiac pacing.