【摘要】 目的探讨双腔起搏器术后心房颤动(房颤)发生的情况及相关危险因素。方法选取2014年1月至2017年12月于泰州市人民医院首次植入永久起搏器的156例患者,分为病态窦房结综合征(SSS)组81例和房室传导阻滞(AVB)组75例,回顾性收集患者病史资料,术后平均随访3.9年,观察患者房颤发生情况,比较2组患者房颤首发时间及房颤负荷,并通过logistic回归分析双腔起搏器术后发生房颤的危险因素。结果所有患者总体的房颤发生率随着随访时间增加呈逐渐升高趋势,AVB组房颤发生率较SSS升高趋势更缓慢,且SSS组房颤发生率较AVB组明显升高(χ~2=7.64,P<0.01)。SSS组首次发生房颤时间比AVB组早(t=4.79,P<0.01),SSS组房颤负荷较AVB组高(t=4.972,P<0.01)。logistic回归分析发现右室心尖部起搏(B=0.05,OR=2.627,95%CI 1.334～7.572,P=0.017)、心室起搏比例(B=-0.028,OR=4.717,95%CI 1.425～11.83,P=0.003)是双腔起搏器术后房颤发生的独立危险因素。结论 SSS组首次发生房颤时间较AVB组早,且房颤负荷更高;右室心尖部起搏和心室起搏比例是双腔起搏器术后房颤发生的独立危险因素。更多还原

【Abstract】 Objective To investigate the incidence of atrial arrhythmias and related risk factors after dual chamber pacemaker surgery.Methods 156 patients with permanent pacemaker implantation in Taizhou People’s hospital from January 2014 to December 2017 were selected and divided into sick sinus syndrome(SSS) group(81 cases) and atrioventricular block(AVB) group(75 cases).The patients’ medical history was retrospectively collected and followed up for an average of 3.9 years.The incidence of atrial arrhythmia was observed, the onset time of atrial fibrillation and the load of atrial fibrillation were compared between the two groups, and the risk factors of atrial arrhythmia after dual chamber pacemaker operation were analyzed by logistic regression.Results The overall incidence of atrial fibrillation in all patients increased gradually with the increase of follow-up time.The incidence of atrial fibrillation in AVB group was slower than that in SSS group, and the incidence of atrial fibrillation in SSS group was significantly higher than that in AVB group(χ~2=7.64,P<0.01).The first time of atrial fibrillation in AVB group was earlier than that in SSS group(t=4.79,P<0.01),and the load of atrial fibrillation in SSS group was higher than that in AVB group(t=4.972,P<0.01).Logistic regression analysis showed that right ventricular apical pacing(RVAP)(B=0.05,OR=2.627,95% CI 1.334-7.572,P=0.017),ventricular pacing ratio(VP)(B=-0.028,OR=4.717,95% CI 1.425-11.83,P=0.003) were independent risk factors for atrial arrhythmia after dual chamber pacemaker surgery.Conclusion The onset time of atrial fibrillation in patients with sick sinus syndrome is earlier than that in patients with atrioventricular block, and the load of atrial fibrillation is higher.Right ventricular apex pacing and ventricular pacing ratio are independent risk factors for atrial fibrillation after dual chamber pacemaker surgery.更多还原