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1、DDD起搏器选择心室起搏部位对血流动力学的影响?508?中国心脏起搏与心电生理杂志2007年第2l卷第6期DDD起搏器选择心室起搏部位对血流动力学的影响洪鹭蓉吴少平黄小洪郑桂安[摘要]目的比较右室间隔部(RVS)和右室心尖部(RVA)起搏对m流动力学的影响.方法42例置入DDD起搏器的患者,分为RVS组和RVA组;比较2组术前和术后3个月随访的左窀射血分数(LVEF),心脏指数(cI),每搏量(sV),左室最大压力上升速率(dp/dtmax),左室最大压力下降速率(一dp/dt珊似),二尖瓣血流E峰和A峰最大充盈速度比值(E/A),等容舒张时问(IVRT)差
2、异.结果与术前相比,RVA组3个月随访的LVEF,CI,SV,@/dtmax,一/max,E/A,IVRT均显着降低(0.5l±0.04vs0.54±0.03;2.33±0.09L/min?m～vs2.68±0.11L/min?m一:71.11±14.2mlvs80.17±16.12ml;1614±133mmHg/svs1702±155mmHg/s;2230±234mmHg/svs2404±242mmHg/s:1.38±0.47vs1.86±0.28:73.2±3.86msvs77.6±4.15ms,均P<0.05),RVS组无明显变化.3个月随访RV
3、S组LVEF,CISV,SV,dp/dtmax均显着高于RVA组(P<0.05).结论RVS起搏对血流动力学无不良影响.[关键词]心血管病学;右室问隔起搏;右室心尖部起搏;血流动力学中图分类号R318.11文献标识码A文章编号1007—2659(2007)06—0508—03EffectsofventricularpacingwaysonhemodynamlcsinpatientswithimplantedDDDpacemakers.HONGLu—rong,WUShao.ping,HUANGXiao—hong,ZHENGGui—an.Departmen
4、tofCardiology,ZhangzhouMunicipalHospitalAffiliatedtoFujianMedicalUniversity,Zhangzhou363000,Fujian,China[Abstract]ObjectiveTocomparethehemodynamiceffectsofrightventricularseptum(RVS)pacingandrightventric'ularapex(RVA)pacinginpatientswithimplantedDDDpacemakers.Methods42caseswithimpl
5、antedDDDpacemak'elswererandomlydividedintoRVSgroupandRVAgroup;leftventricularejectionfraction(LVEF),cardiacindex(CI),strokevolume(SV),maximumrateofleftintraventricularpressurerise/down(±dp/dtmax),mitralE/Aratio,isovolumerelaxationtime(IVRT)oftwopreoperationgroupsandafteroperationgr
6、oupswith3-monthfollowing—upwerecompared.ResetsComparedwithpre—operation.LVEF,CI,SV,dp/dtmax,一dp/dtmax,E/A,IVRTinRVAgroupdecreasedsig—nificantly(0.51±0.04vs0.54±0.03:2.33±0.09lMmin?mvs2.68-+0.11[/min?m;71.11±14.2mlvs80.17±16.12ml;1614±133mmHsvs1702±155mmHs;2230±234mmHg/svs2404±242mm
7、Hg/s;1.38±0.47vs1.86±0.28;73.2±3.86msvs77.6±4.15ms,allP<0.05),nosignificantchangeinRVSgroup.ComparedwithRVAgroup.LVEF,CISV,SV,dp/dtmaxinRVSgroupincreasedsignificantlyafter3-monthfollow—up.ConclusionsRVSpacinghasnonegativeeffectsonhaemodynamics.[ChineseJournalofCardiacPacingandEl
8、ectrophysiology,2007,21(6)
