老年人应用心脏起搏器原因探讨

目的：了解老年人植入埋藏式心脏起搏器的病因。方法：将1987－1998年间270例首次入院植入心脏起搏器的临床资料进行回顾性分析。结果：①270例中，老年退行性心脏瓣膜病（SDHVD）占71．5％，是老年患者植入心脏起搏器的首要病因；②无论合并或不合并其他器质性心脏病而需植入起搏器的SDHVD患者中，传导阻滞的发生均多于病态窦房结综合征。结论：老年患者已成为心脏起搏治疗的主要人群且以SDHVD引起的心脏传导系统障碍为最常见。

Etiological Survey of Senile Patients with Pacemaker Implanted

: To survey the reason for pacemaker implanting in the senile patients. Methods: Using the methods of retrospective survey study, 270 senile patients who had intact clinical data during 1987-1998 for the first implantment were analysed. Results: 1. The senile patients was becoming major population which need pacemaker implanted. 2.The first reason for install the pacemaker in senile patients was senile degenerative heart valvular disease (SDHVD) , since about 68% patients were suffered from it. 3. The occurrence of conduction block was more often than sick sinus syndrome among these patients, whether the other organic heart disease were accompanied with SDHVD or not. 4. 16 patient diagnosed with myocardial infarction were installed pacemaker and had no manifestation of SDHVD in echocardiography. Selective coronary angiography was performed in 6 patients and the results demonstrated that the dysfunction of heart conduction system was discordant with myocardium ischemia and might relate with SDHVD itself. Conclusion: Senile patients are the main population which need pacemaker and dysfunction of conduction system caused by SDHVD is the first reason for implanting pacemaker.