75例选择性右室流出道间隔部起搏对心功能影响临床观察(1)
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【摘要】 目的 探讨流出道室间隔起搏对心功能的影响。方法 选择心动过缓住院患者75例，行选择性右室流出道间隔部起搏，观察术前及术后一周内左房内径(LAD)、左室舒张末内径(LVEDD)、左室射血分数(LVEF)及美国纽约心脏病学会(NYHA)心功能分级等指标。结果 75例患者均顺利完成间隔起搏植入手术，其中LVEF正常者，术后有提高LVEF，缩小LAD和LVEDD趋势(P>0.05)；LVEF低于正常非心房颤动者，间隔起搏能提高LVEF(P>0.05)，缩小LAD、LVEDD(P<0.05)，改善心功能；LVEF低于正常合并心房颤动者，室间隔起搏有明显提高LVEF、缩小LAD、LVEDD趋势(P<0.05)。按NYHA心功能分级，术后心功能显著改善(P<0.01)。结论 对于有安装埋藏式起搏器适应证的患者，施行流出道室间隔起搏能改善心功能，是安全可行的，但仍需进行远期观察。
【关键词】 室间隔起搏；左房内径；左室舒张末内径；左室射血分数
文章编号：1003-1383(2011)06-0700-03 中图分类号：R 541.7 文献标识码：A
doi:10.3969/j.issn.1003-1383.2011.06.005
Clinical observation of 75 cases with selective RVOTSP and its influence on heart function
CHEN Xin,CHEN Gang,LI Ke
(Huangli Branch Institute of Wujin District People's Hospital,Changzhou, Jiangsu 213100)
【Abstract】 Objective To explore the effect of ventricular outflow tract septum pacing on heart function.
Methods 75 hospitalized patients (38 male and 37 females) with bradycardia were chosen to undergo selective right ventricular outflow tract septum pacing(RVOTSP).Left atrial diameter (LAD),left ventricular end-diastolic diameter (LVEDD),left ventricular ejection fraction (LVEF) and New York heart Association (NYHA) cardiac function classification indexes and other indexes were observed before and after the surgery.
Results 75 patients were successfully implanted pacemakers by septal pacing.For those with the LVEF normal,it can improve postoperative LVEF,reduce LAD and LVEDD;For the LVEF below normal,it can increase stroke volume,reduce LAD and LVEDD,improve heart function.For the LVEF below normal,especially for those with atrial fibrillation, it can statistically significantly improve LVEF,reduce LAD,LVEDD.According to NYHA class,cardiac function was improved in varying degrees.
Conclusion For the patients with implantable pacemakers installation indications, the implementation of the outflow tract septal pacing, which can improve heart function, is safe and feasible. But long term observation is still necessary.
【Key words】 ventricular septal pacing; left atrial diameter;left ventricular end-diastolic diameter;left ventricular ejection fraction ......
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