【摘要】 ①目的观察生理性与非生理性起搏对心房颤动和心功能的影响。②方法安装永久性心脏起搏器治疗的103例病态窦房结综合征病人,其中,生理性起搏者包括心房按需起搏(AAI)及右室双腔起搏(DDD)共47例,非生理性起搏即心室按需起搏(VVI)者56例,对其心房颤动的发生情况和心功能状况进行自身和组间对比分析。③结果生理性起搏者心脏左房射血分数(LVEF)较起搏前明显增加(t=4.53,P<0.01),E/A比值亦显著升高(t=2.16,P<0.05);而非生理性起搏者LVEF较起搏前明显降低(t=7.29,P<0.01),左房内径(LAD)明显增大(t=5.28,P<0.01),E/A比值下降(t=2.29,P<0.05),左室收缩及舒张末期内径(LVDd)增大(t=2.48,P<0.05)。术后6月两组病人LVEF、E/A比值、LAD、LVDd相比,差别有显著意义(t=5.54~8.13,P<0.01)。生理性起搏组心房颤动的发生率由术前的44.7%降至术后的12.8%(χ2=11.7,P<0.01),非生理性起搏组发生率由术前的32.1%上升至术后的46.4%(2χ=10.4,P<0.01)。术后两组间心房颤动发生率相比,差别有显著统计学意义(χ2=13.5,P<0.01)。④结论生理性起搏可以降低快速性房性心律失常尤其降低心房颤动发生率,改善心功能。更多还原

【Abstract】 Objective To assess the effects of physiologic and nonphysiologic pacing on atrial fibrillation and cardiac function. Methods Of 103 sick sinus syndrome patients who had implanted pacemakers, 47 patients were physiologic pacing (AAI, DDD) and 56 were nonphysiologic pacing (VVI). The changes of atrial fibrillation and cardiac function between this two groups were investigated and analyzed. Results After the operation, the LVEF and E/A increased (t=4.53,P<0.01;t=2.16,P<(0.05)) while the incidence of atrial fibrillation decreased (~2=11.7,P<0.01) in physiologic pacing group. But in the nonphysiologic pacing group, the LVEF and E/A decreased (t=7.29,P<0.01;t=2.29,P<0.05), while LAD and LVDd increased (t=5.28,(P<)0.01; t=2.48,P<0.05) and the incidence of atrial fibrillation increased (~2=10.4,P<0.01). The difference in LVEF, E/A, LAD, LVDd and incidence of the atrial fibrillation were significant between the two groups after operation (t=5.54-8.13,P<(0.01); ~2=13.5,P<0.01). Conclusion Phsiologic pacing could decreace the incidence of artificial fibrillation and improve the cardial function.更多还原