右心室流入道起搏QRS波时限对心功能的影响(1)
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2010年12月1日
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[摘要]目的观察采用右心室流入道起搏治疗缓慢性心律失常时，QRS时限对心功能的影响及与心力衰竭的关系。方法 随意选用64例病态窦房结综合征或三度房室传导阻滞的患者，采用右心室流入道起搏治疗，将患者起搏时QRS时限<133ms的分为A组(n=34)；起搏时QRS时限≥133ms的分为B组(n=30)， 测量起搏器植入时、起搏3个月和6个月不同时期，QRS时限、血浆心钠肽(BNP)、心排血量(CO)、每搏输出量(SV)、射血分数(EF)和左室舒张末内径(LVDd)的变化。结果 术后即刻测两组QRS时限、BNP值和心脏超声指标无显著性差异(p>0.05)，术后3个月、6个月QRS时限、LVDd 、BNP ，B组明显高于A组，而EF、SV、CO，B组明显低于A组。 结论 右室流入道起搏部位QRS时限和心功能密切相关，QRS时限越宽，心功能纠正就越不明显或心衰进一步加重，反之，QRS时限越窄，心功能改善就越明显。
[关键词]右心室流入道； 起搏治疗； QRS时限； 心功能
[中图分类号] R541[文献标识码]A [文章编号] 1005-0515(2010)-12-016-02
QRSintervalinfluenceoncardiacfunctionin patientswithrightventricularinflowtractpacing
ZHANG Gui-sheng,Zhang Ting-ting，LiLonggui
( Shanghai Armed Police Hospital , Shanghai201103)
[Abstract]ObjectiveTo observe when using right ventricular inflow tract pacing in patients with slow arrhythmias, the impact QRS interval on cardiac function and the relationship with the heart failure. Methods Randomly selected 64 patients with sick sinus syndrome or third degree atrioventricular block ,treatment with right ventricular inflow tract pacing, The patients were divided into A group (n=34) whoseQRS interval <133ms when be paced and B group (n=30) whose QRS interval ≥133ms when be paced.Measured QRS interval, plasma cardiac natriuretic peptide (BNP), cardiac output (CO), stroke volume (SV), ejection fraction (EF) and left ventricular end diastolic diameter (LVDd) changes in pacemaker implantation, pacemaker 3 months and 6 months after .ResultsImmediately after testing, there was nosignificant difference (p> 0.05) in two groups of QRS time, BNP values and the parameters of echocardiography.After 3 months, 6 months, in B group , the parameters of QRS time, LVDd, BNP was significantly higher than A group, and EF, SV, CO, B group was significantly lower than A group. Conclusion At the right ventricular inflow tract pacing site, QRS duration and cardiac function were closely related, the wider QRS time frame, the less obvious in the improvement of cardiac function or the heart failure further increased, whereas, the more narrow QRS time frame, improved heart function better ......
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