起搏器心室自身优先功能对累计心室起搏比例及心功能的影响

目的观察具有心室自身优先（VIP）功能的起搏器对累计心室起搏比例及心脏功能的影响。方法选择因缓慢性心律失常安装心脏起搏器的患者62例。所有患者均为心房电极位于右心耳，心室电极位于右室心尖部；根据植入后是否开启心室自身优先功能分为观察组30例和对照组32例，分别在置人前及置人后12个月进行随访，观察2组累计心室起搏比例、左房内径（LAD）、左室射血分数（LVEF）、左室舒张末期内径（LVEDD）、血浆脑钠肽（BNP）水平及6min步行试验距离。结果术后12个月，与对照组比较，观察组LAD[（39．38±4．16）mmvs（43．41±5．34）mm]、LVEDD[（47．12±7．22）mmvs（51．76±9．26）mm]显著降低，LVEF（0．60±0．08vs0．55±0．11）升高，6min步行试验距离[（339．79±45．82）mvs（314．38±41．74）m]更长（P〈0．05），BNP水平[（108．23±62．10）ng／lvs（143．87±72．85）ng／1]显著降低（P〈0．05），累计心室起搏比例（0．21±0．08vs0．55±0．12）明显降低（P〈0．01），而房颤负荷差异无统计学意义（P〉0．05）。结论VIP功能可以明显减少累计心室起搏比例，并保护心功能。

Influence of ventricular intrinsic preference algorithm on the percentage of right ventricular pacing and heart function

Objective To investigate the impacts of ventricular intrinsic preference （VIP） algorithm on percentage of right ventricular pacing and heart function. Methods A total of 62 patients received permanent cardiac pacemaker for brady arrhythmias were enrolled. All patients were located in the right atria] appendage, ventricular electrode in the right ventricular apex; implant is turned on according to their own priorities ventricular function divided into observation group（30 cases） and control group （32 cases）, before and after implantation in 12 months follow-up, two groups were observed cumulative propor- tion of ventricular pacing, left a~ial diameter （LAD）, left ventricular ejection fraction （LVEF）, left ventricular end-diastolic diameter （LVEDD）, brain natrihr~etic peptide （BNP） levels and 6 min walk test distance. Results After 12 months, compared with the control group, the observation group LAD[（39.38 ± 4. 16） mm vs. （43.41 ± 5.34） mm], LVEDD [ （47.12 ±7.22） mm vs. （51.76 ± 9.26） mm] was significantly decreased, LVEF （0.60± 0.08 vs. 0.55 ±.11） elevated, 6 min walk test distance [ （339.79 ±45.82） m vs. （314.38 ±1.74） m] was longer （ P 〈0.05）, BNP levels [ （108.23±2.10） ng/L vs. （143.87 ±2.85） ng/L] decreased significantly（ P 〈0.05）, the cumulative percentage of ventricular pacing （0.21 ±0.08 vs. 0.55 ±0. 12） was significantly lower （ P 〈 0.01 ）, and atrial fibrillation load the difference was not statistically significant （ P 〉 0.05 ）. Conclusion Ventricular intrinsic preference algorithm can effectively reduce the percentage of ventricular pacing, protect heart function.