【摘要】 目的:比较右室心尖部(RVA)和右室流出道(RVOT)间隔部起搏对心功能和左心室收缩同步性的影响。方法:选择原为心室起搏(VVI)心尖部起搏、现需更换起搏器的患者2例和心动过缓需安装起搏器的新患者33例,共35例。评估QRS波宽度、S-QRS间期,并行常规超声心动图(UCG)检查,测左室射血分数(LVEF)、左室短轴缩短率(FS)。测量左室12个节段的QRS波起始点至各节段收缩期达峰时间(Q-Ts)和左室12个节段的Q-Ts最大差值(Max-ΔTs)。结果:RVOT起搏组的S-QRS间期较RVA起搏组缩短[(31.35±7.27)msvs(54.35±9.03)ms](P<0.05)。RVOT起搏组的QRS时限较RVA起搏组缩短[(72.44±10.36)msvs(91.47±10.56)ms](P<0.05)。与RVOT起搏相比,RVA起搏术后1d的LVEF、FS均降低(P<0.05)。RVA起搏组的左室各壁基底段和中间段Q-Ts与RVOT起搏组相比,均延长(P<0.01)。结论:RVOT起搏较RVA起搏对左室收缩功能的影响小,是一种较为理想的起搏部位。更多还原

【Abstract】 Aim:To study differences of right ventricular apex (RVA) and the right outflow tract (RVOT) spetal paceing of cardiac function and synchronization with left ventricular contraction.Methods:A total of 2 cases of pacemaker patients for the apex VVI pacing to be replaced and 33 cases of bradycardia to install a pacemaker were collected.QRS width,S-QRS interval,parallel conventional echocardiography (UCG) inspection,and LVEF,FS were detected.Left ventricular 12 segments of the QRS complex starting point to sections of the systolic peak time (Q-Ts) and left ventricular 12 segments of the Q-Ts largest margin (Max-ΔTs) were detected.Results:The S-QRS interval of RVOT group was significantly shorten than that of RVA group[(31.35±7.27)ms vs (54.35±9.03)ms](P<0.05). The QRS duration significantly shorten than that of RVA group[(72.44±10.36)ms vs (91.47±10.56)ms](P<0.05).Compared with RVOT group,the LVEF,FS of RVA group one day after pacing were lower (P<0.05).The left ventricular pacing of the basement wall,and the middle of the Q-Ts of RVOT group was significantly shortened compared with RVA group (P<0.01).Conclusion:RVOT pacing is small effect on left ventricular systolic function,it is an ideal location pacing.更多还原