起搏器的休息频率功能对房性心律失常的近期影响

目的探讨起搏器的休息频率功能对房性心律失常的近期影响,评估其临床疗效和安全性。方法选择植入Identity Adx DDD 5286型双腔起搏器的病态窦房结综合征患者39例。起搏器植入后不打开休息频率,保持起搏器出厂设置;术后3个月随访时程控为在双腔起搏模式下打开休息频率,共随访6个月。比较起搏器植入前后及打开心房滞后模式后心房起搏百分比及房性心律失常的发生情况。结果与术前比较,术后3个月24 h动态心电图显示,房性期前收缩次数和房性心动过速、心房颤动阵数增加(U=4.19、4.28和4.39,均为P<0.05),相应的发作例数也增加(χ2=4.57、4.61和4.96,均为P<0.05)。与未打开休息频率模式比较,打开后心房的起搏百分比明显降低56%(40%⁷3%)比84%(64%73%)比84%(64%⁹7%),P=0.03];24 h动态心电图显示,房性期前收缩次数和房性心动过速、心房颤动阵数明显减少(P<0.01),相应的发作例数也减少(P<0.01)。结论休息频率模式可以减少心房起搏的比例,减少房性心律失常的发生;打开休息频率模式安全可靠。

Short term effects of rest frequency function of the pacemaker on atrial arrhythmia

Objective To explore the short term effects of rest frequency function of the pacemaker on atrial arrhythmia.Methods A total of 39 cases with sick sinus syndrome that had implanted dual chamber pacemaker of Identity Adx DDD 5286 were chosen.The rest frequency was not opened right after pacemaker implantation,and kept the pacemaker settings.Rest frequency was opened in dual chamber pacing mode at 3 months after pacemaker implantation and were followed up for 6 months.The percentage of atrial pacing and the occurrence of atrial tachyarrhythmias were compared before and after pacemaker implantation and atrium lag mode opened.Results The numbers of DCG 24 h atrial premature beats,atrial tachycardia and atrial fibrillation after 3 months were significantly increased compared with preoperative （the U values were 4.19,4.28 and 4.39,respectively,all P 〈 0.05）,the episode cases were also increased （the x2 values were4.57,4.61 and 4.96 respectively,all P 〈 0.05）.After the rest frequency mode opened,the percentage of atrial pacing was decreased significantly 56% （40%-73%） vs.84% （64%-97%）,P =0.03].The numbers of DCG 24 h atrial premature beats,atrial tachycardia and atrial fibrillation were significantly decreased （P 〈 0.05）,the episode cases were also decreased significantly （P 〈 0.05）.Conclusions The rest frequency mode could reduce the frequency of atrial pacing and the occurrence of atrial arrhythmias.The rest frequency mode is safe and reliable.