自身房室传导搜索功能对心室起搏百分比的影响(1)
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[摘要] 目的：探讨双腔起搏器使用自身房室传导搜索功能(autointrinsic conduction search，AICS)对右心室起搏百分比的影响。方法：选取本院2008年6月~2011年6月成功植入St Jude公司双腔起搏器(型号为5376或5386)的患者50例。分别观察打开和关闭AICS功能1个月后患者右心室起搏百分比的变化及测试血浆脑利钠肽(BNP)值。结果：使用AICS功能后，与关闭AICS功能后比较，心室起搏比例明显下降[(4.2±1.3)% vs (43.3±7.1)%]，BNP水平亦明显降低[(57.3±22.4)pg/ml vs (377.7±42.5)pg/ml]，差异有高度统计学意义(P<0.01)。结论：双腔起搏器使用自身房室传导搜索功能可明显减少心室起搏百分比，鼓励自身房室传导，减少起搏器电池耗竭，改善心功能。
[关键词] 双腔起搏器；自身房室传导搜索；心室起搏比例；脑利钠肽
[中图分类号] R541 [文献标识码] B [文章编号] 1673-7210(2011)12(b)-162-02
Effect of autointrinsic conduction search fuction on ventricular pacing percentage
WANG Wei, YANG Xili, LI Jianmin
Department of Cardiology, the First People's Hospital of Foshan City, Guangdong Province, Foshan 528000, China
[Abstract] Objective: To assess the efficacy of the decrease of right ventricular pacing percentage by the dual-chamber pacemaker with autointrinsic conduction search (AICS). Methods: A total number of fifty patients implanted St Jude's DDD or DDDR (5376 or 5386) from June 2008 to June 2011 in our hospital. The percentages of right ventricular pacing were interrogated when the AICS functions were programmed "on" or "off" for 1 month. At the same time, plasma BNP levels were recorded. Results: The percentages of 50 patients' right ventricular pacing when using AICS fuction were decreased significantly [(4.2±1.3)% vs (43.3±7.1)%], plasma BNP levels were also significantly reduced [(57.3±22.4) pg/ml vs (377.7±42.5) pg/ml], the difference was statistically significant (P<0.05). Conclusion: AICS fuction in the dual-chamber pacemaker effectively promotes intrinsic ventricular activation and substantially reduces unnecessary ventricular pacing, it can reduce the pacemaker battery depletion.
[Key words] Dual chamber pacemaker; Autointrinsic conduction search; Ventricular pacing percentage; BNP
双腔起搏器具有心房和心室双腔起搏与感知功能，保持了正常房室同步收缩并能提供一定程度的频率应答，是一种近乎生理状态的起搏器。但长期右室心尖部起搏会导致左、右室间收缩不同步，诱发心力衰竭，从而引起心脏血流动力学的异常[1]。具有自身房室传导搜索功能(autointrinsic conduction search，AICS)的双腔起搏器通过正滞后搜索原理在原本设定的起搏/感知房室间期(PAV/SAV)基础上定时延长或缩短 ......
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