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1、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［摘要］目的：分析生理性起搏对病态窦房结综合征CSSS)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
2、/minvs(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/minvs(4.32±0.31)L/min,(0.99±0.13)vs(0.85±0.11),均PVO.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了拮抗剂，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
3、；心功能；心律失常［中图分类号］R541.7E文献标识码］C［文章编号］1673-7210(2009)05(b)-052-02EffectsofphysiologicpacingonpatientswithsicksinussyndromeandparoxysmalatrialfibrillationMENGLiang,QIGuoxian,YUBo(DepartmentofCardiology,theFirstAffiliatedHospitalofChineseMedicalUniversity,Shenyangll0001,China)［Abstract］Objecti
4、ve:Toanalyzetheinfluenceofphysiologicpacingonlong-termcardiacfunctionandatrialarrhythmiaofpatientswithsicksinussyndrome(SSS)andparoxysmalatrialfibrillation(AF)0Methods:Arestrospectiveanalysiswasmadein115patientswithSSSandparoxysmalAFbyself-controlstudy.Allofpatientswereimplantedphysiologic
5、pacemakers(DDD/AAIpacemakers)throughvenasubclariapuncture.115patientswereregularfollowed-upatthefirst,thethird,thesixthandthetwelfthmonthafterimplantationandonetimeperyearthereafter,toobservethestationofpacemakers,cardiacfunctionandleftatrialsizetheoccurrenceofAFandothercomplications.Resul
6、ts:Meanfollowupwas(26.3±3.2)months,thepatientshadhigherleftventricularejectfraction(LVEF),cardiacoutput(CO)andtheratioofE/Aaftertheimplantation［DDD:(52.1±5.7)%vs(45.8±8.2)%,(4.89±0.55)L/minvs(4.15±0.59)L/min(1.02±0.25)vs(0.91±0.09);AAI:(52.3±6.2)%vs(43.9±1.2)%,(5.07±0.62)L/minvs(4.32±0.31)
7、L/min,(0.99±0.13)vs(0.85±0.11)respective!y,allP<0.01］•However,theleftatrialdiameter(LAD)hadlesschangesofthe115patients,82patientshadnotheoccurrenceofAFaftertheimplantation,15patientshadnotheoccurrenceofAFaftertheuseofAmiodaroneaswell,15patientshadtousecalciuma
