右室间隔部与心尖部起搏对心脏功能影响的随机对照研究

目的:对比右室心尖部起搏与右室间隔部起搏对心功能的影响。方法:102例病窦综合征和高度房室传导阻滞患者随机入选右室心尖部起搏组(50例)和右室间隔部起搏组(52例),术后随访患者的心功能及左室舒张末期内径等相关指标。结果:术后随访18个月右室间隔部起搏组患者心功能和左室舒张末径较手术前相比无明显变化。右室心尖部起搏组患者心功能较手术前明显降低,左室舒张末径较手术前有增加的趋势,但差异无显著性。两组相比,右室心尖部起搏组患者左室射血分数较间隔部起搏组患者低,两组左室舒张末期内径无明显差异P>0.05。结论:右心室间隔部起搏是安全、有效的,比右心室心尖部起搏更有利于双心室电激动的同步性,且不会给心功能带来明显不良影响。

The randomization study of comparation of cardiac function impact by right ventricular septum pacing and right ventricular apex pacing

Objective:To compare the cardiac function impact by right ventricular septum pacing and right ventricular apex pacing.Methods:One hundred and two patients with sick sinus syndrome and severe atrioventricular block were devided to right ventricular apex pacing group(52patients) and right ventricular septum pacing group(50 patients).We followed up cardiac function and left ventricular diastolic diameter(LVDd) after pacing.Results:After 18 months follow up,cardiac function and LVDd were similar in right ventricular septum pacing group.Cardiac function were decreased in right ventricular apex pacing group.LVDd were similar in right ventricular apex pacing group.Cardiac function in right ventricular apex pacing group were lower than right ventricular septum pacing group.LVDd were similar in two groups.Conclusions:Right ventricular septum pacing is as safe and effecient as right ventricular apex pacing,while right ventricular septum pacing is more beneficial to the biventricular electrical synchronism and brings less negative effect to cardiac function.