心脏永久性起搏器的不同起搏部位对植入患者心功能的影响

目的 探讨心脏永久性起搏器的不同起搏部位对植入患者心功能的影响.方法 我院心血管内科接受心脏永久性起搏器植入术的患者80例,根据患者起搏部位将其分为A组(30例,于右心室心尖部植入心脏永久性起搏器)、B组(50例,于右心室间隔植入心脏永久性起搏器),对两组的临床资料进行回顾性研究分析,比较两组的N末端脑钠肽水平(N-t...

Effect of different pacing sites of permanent pacemaker on cardiac function of implanted patients

ObjectiveTo explore the effect of different pacing sites of permanent pacemaker on cardiac function of implanted patients.MethodsIn total, 80 patients who received permanent pacemaker implantation in the Department of Cardiology of our hospital were included in the study, and were divided into group A(30 patients with permanent pacemaker implantation at the apex of the right ventricle) and group B(50 patients with permanent pacemaker implantation at the septum of the right ventricle) according to the pacing sites. The clinical data of the two groups were analyzed retrospectively. The levels of N-terminal brain natriuretic peptide(NT-proBNP), cardiac color ultrasound indicators［including left ventricular end-diastolic diameter(LVEDD), left ventricular end-systolic diameter(LVESD) and left ventricular ejection fraction(LVEF)］, quality of life score, and incidence of adverse cardiac events were compared between two groups.ResultsThe levels of NT-proBNP after implantation in both groups were significantly lower than those before implantation(P＜0.05), while the levels of NT-proBNP after implantation in group B were lower than those in group A, suggesting significant differences(P＜0.05). The LVEF, LVEDD and LVESD after implantation were significantly improved in both groups(P＜0.05), while the LVEF in group B was higher than that in group A(P＜0.05), and the LVEDD and LVESD in group B were lower than that in group A, with significant difference(P＜0.05). The quality of life scores(emotional field, physical field, other fields and comprehensive scores) of the two groups were significantly lower after implantation than those before implantation(P＜0.05), while the quality of life scores(emotional field, physical field, other fields and comprehensive scores) after implantation in group B were lower than those in group A, with statistical significance(P＜0.05). At 6-month follow-up, there were 2 cases of atrial fibrillation, 1 case of heart failure and 2 cases of abnormal heart rate in group A, and 3 cases of atrial fibrillation, 3 cases of heart failure and 1 case of abnormal heart rate in group B. The incidence of adverse cardiac events in group A and group B was 16.67% and 14.00% respectively, and there was no significant difference between two groups(P＞0.05).ConclusionImplantation of permanent cardiac pacemakers at different pacing sites has certain influences on patients′ cardiac function. Implantation of permanent cardiac pacemakers into the right side of the interventricular septum can improve patients′ cardiac function better without increasing the risk of adverse cardiac events.