生理性起搏治疗病态窦房结综合征合并阵发性房颤的疗效观察(1)
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[摘要] 目的：分析生理性起搏对病态窦房结综合征(SSS)合并阵发性心房颤动(AF)患者心功能及房性心律失常的影响。方法：115例SSS合并阵发性AF患者置入生理性起搏器(DDD、AAI起搏器)。术后分别于1、3、6和12个月进行随访，1年后每年随访1次。观察起搏器工作状态、心功能及左房内径有无变化，有无AF及其他并发症。结果：术后平均随访(26.3±3.2)个月，左室射血分数(LVEF)、心输出量(CO)、E/A比值明显增加[分别为DDD起搏器组：(52.1±5.7)% vs(45.8±8.2)%，(4.89±0.55) L/min vs(4.15±0.59) L/min，(1.02±0.25)vs(0.91±0.09)；AAI起搏器组：(52.3±6.2)%vs (43.9±1.2)%，(5.07±0.62) L/min vs (4.32±0.31) L/min，(0.99±0.13)vs (0.85±0.11)，均P<0.01]，左房内经(LAD)无明显变化。115例中82例患者未并发AF，15例服用胺碘酮后未复发，15例有较多房早而长期服用钙离子拮抗剂，3例转为持续性AF而改为VVI起搏。结论：生理性起搏对SSS并发的阵发性AF的发生有抑制作用，同时有助于患者远期心功能的改善。
[关键词] 生理性；心脏起搏；心功能；心律失常
[中图分类号] R541.7[文献标识码]C [文章编号]1673-7210(2009)05(b)-052-02
Effects of physiologic pacing on patients with sick sinus syndrome and paroxysmal atrial fibrillation
MENG Liang, QI Guoxian, YU Bo
(Department of Cardiology, the First Affiliated Hospital of Chinese Medical University, Shenyang110001, China)
[Abstract] Objective: To analyze the influence of physiologic pacing on long-term cardiac function and atrial arrhythmia of patients with sick sinus syndrome(SSS) and paroxysmal atrial fibrillation(AF)。Methods: A restrospective analysis was made in 115 patients with SSS and paroxysmal AF by self-control study. All of patients were implanted physiologic pacemakers(DDD/AAI pacemakers)through vena subclaria puncture.115 patients were regular followed-up at the first, the third,the sixth and the twelfth month after implantation and one time per year thereafter,to observe the station of pacemakers, cardiac function and left atrial size the occurrence of AF and other complications. Results: Mean follow up was (26.3±3.2)months, the patients had higher left ventricular eject fraction(LVEF),cardiac output(CO) and the ratio of E/A after the implantation [DDD:(52.1±5.7)% vs (45.8±8.2)%,(4.89±0.55)L/min vs (4.15±0 ......
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