VVI单腔起搏器置入右心室流出道起搏的疗效观察及比较研究

目的观察并比较VVI单腔起搏器置入右心室流出道和右心室心尖部对心动过缓患者6个月后心脏电机械同步性的影响。方法入选20例房颤伴房室传导阻滞及心动过缓需置入VVI单腔起搏器的患者，将右心室流出道起搏的患者10例作为治疗组，同时行右心室心尖部起搏的另外10例作为对照组。观察并比较置人起搏器前后两组的起搏参数、QRS宽度、心功能和生活质量评分情况。结果随访6个月时，两组在起搏阈值、感知阈值、电极阻抗方面差异无统计学意义[（0.48±0．1）mV和（0．56±0．12）mV；（14．7±1．2）V和（12．6±2．3）V；（904±56）Ω和（（815±45）Ω，P〉0．05]，而右心室流出道起搏组的QRS宽度明显缩短[（108．3±11．2）ms和（134．5±12．6）ms，P〈0．05]，且心功能和生活质量评分明显改善[（58．9±2．5）％和（54．3±2．5）％，61．8±2．3和56．2±5．1，P〈0．05]。结论VVI单腔起搏器置入右心室流出道起搏较心尖部起搏更接近生理情况，能增加患者的心脏电机械同步性，提高心功能及改善预后。

Observation and comparison of VVI single-chamber pacemakers by pacing the right ventricular outflow tract

Objective To explore the effects of VVI single-chamber pacemakers on electrical-mechanical synchronization by pacing the right ventricular apex(RVA) or the right ventricular outflow tract (RVOT) 6 months follow-up in patients with bradycardia. Methods This study included 20 patients with atrial fibrillation concomitant with atrial-ventricular block and bradycardia, which were divided into 2 groups: RVA pacing group and RVOT pacing group. Patients were evaluated and compared for pacing parameters, QRS width,...