右心室流出道起搏和右心室心尖部起搏的临床观察

目的比较右心室流出道起搏和右心室心尖部起搏对心脏功能的影响。方法将安装埋藏式DDD心脏起搏器的患者随机分成右心室流出道起搏组和右心室心尖部起搏组,比较两组患者术后的QRS波宽度、术前和术后的左心室舒张末内径(LVEDD)、左心室射血分数(LVEF)、左房内径(LA)。结果两组患者QRS波宽度间差异有统计学意义(P<0.05);术后3个月及6个月时,LVEDD、LVEF、LA间比较差异无统计学意义(P>0.05)。结论右心室流出道起搏和右心室心尖部起搏对患者LVEDD、LVEF和LA的影响无差别,但右心室流出道起搏者的QRS波宽度明显较窄。

Clinical Observation of Right Ventricular Outflow and Right Ventricular Apex Pacing

Objective To compare the effects of right ventricular outflow pacing and right ventricular apex pacing on cardiac function.Methods Forty patients with DDD pacemaker implantation were randomly divided into right ventricular outflow pacing group and right ventricular apex pacing group depending on the position of ventricular lead.The QRS durations after operation were compared between the two groups.The left ventricular end diastolic diameter(LVEDD),left ventricular ejection fraction(LVEF),and left atrial diameter(LAD)were compared before and after operations.Results There was no significant difference in LVEDD,LVEF,and LAD by echocardiography between the two groups before operation.After operation the QRS duration of right ventricular apex pacing was significantly longer than that of right ventricular outflow pacing.After three months and six months follow-up,the LVEDD,LVEF,and LAD between the two groups were not significantly changed,but in the right ventricular apex pacing group there was a decreased tendency in LVEF.Conclusion The QRS duration was shorter in the right ventricular outflow pacing than that in the right ventricular apex pacing.However,there was not significant difference between the two groups.