不同部位右室起搏对心功能的影响

目的:比较右室心尖部起搏与右室间隔部起搏对心功能的影响. 方法:将48例高度房室传导阻滞患者随机分为右室心尖部起搏组(25例)或右室间隔部起搏组(23例).随访术后的超声心动图左室舒张末期内径和射血分数变化以及临床的NYHA心功能分级变化. 结果:24个月后,右室间隔部起搏组左室舒张末期内径,射血分数及NYHA分级较术前无明显变化.但右室心尖部起搏组与术前相比,左室舒张末期内径有增大趋势,射血分数显著减低,NYHA心功能分级级别增高.结论:右室间隔部起搏较右室心尖部起搏更有利于双心室电激动的同步性,且不产生对心功能的不良影响.

Effect of different right ventricular pacing sites on cardiac function

Objective:To assess the effect of different right ventricular pacing sites on cardiac function. Methods: A cohort of 48 consecutive patients with sick sinus syndrome and high-degree atrioventricular block were randomized to right ventricular apex pacing group (n = 25) and right ven-trieular septum pacing group (n = 23). The changes in left ventricular diastolic diameter (LVDd), e-jection fraction and NYHA class during follow-up were evaluated by echocardiography. Results:24 months after implantation of pacemakers, LVDd and ejection fraction were unchanged in the right ventrieular septum pacing group, but LVDd was increased and ejection fraction was decreased and NYHA class increased in patients with ventricular apex pacing. Conclusion: Compared with right ventricular apex pacing, right ventricular septum pacing is more beneficial to the biventricular electri-cal synchronism and exerts less negative effect on ventricular function.