【摘要】 为了解心脏固有心率 (IHR)的变化对心房起搏后病窦综合征 (SSS)合并阵发性心房扑动 (AFL)和心房颤动(AF)发生率的影响 ,采用药物阻断 3 8例 SSS合并阵发性 AFL或 AF患者的心脏自主神经测定其 IHR,根据 Tose提出的正常 IHR标准将其分为 IHR正常组 (18例 )和 IHR异常组 (2 0例 ) ,后行心房起搏治疗。术后进行临床、心电图、2 4 h动态心电图的定期随访 ,随访时间分别为 2 2± 1.9和 2 5± 1.7个月。结果显示 :两组患者起搏器植入后阵发性 AFL、AF发作的频率及每次发作持续时间较植入前均显著减少 (P<0 .0 5 ) ;术后 IHR正常组阵发性 AFL、AF发作的频率及每次发作持续时间显著少于 IHR异常组 (P<0 .0 5 )。所有患者术后生活质量明显改善 ,无心衰、血栓栓塞发生。结果提示 :心房起搏可使 SSS合并阵发性 AFL或 AF的发生减少 ;IHR正常时 ,其作用明显优于IHR异常时。更多还原

【Abstract】 To study the effect of intrinsic heart rate (IHR) on paroxysmal atrial flutter (AFL) and atrial fibrillation (AF) of sick sinus syndrome (SSS) patients implanted atrial pacemaker.After blocking their autonomic nerves and measuring their IHR,38 consecutive cases of paroxysmal AFL and AF of SSS were implanted atrial pacemakers,then they were divided into two groups:normal IHR group ( n =18) and abnormal IHR group ( n =20) by Tose’s normal IHR standard.A long term follow up was carried out in all patients by clinical examination,electrocardiography and dynamic electrocardiography.The mean follow up time was 22±1.9,25±1.7 months respectively.The results showed that the frequency and duration of paroxymal AFL and AF were decreased markedly in two groups compared with those before atrial pacemaker implantation ( P <0.05).After atrial pacemaker implantation,the frequency and duration of paroxysmal AFL and AF in normal IHR group were lessened significantly compared with those of abnormal IHR group ( P <0.05).The life quality of all patients was improved significantly,without heart failure and thrombembolia.These results suggest that atrial pacing is a reliable and safe pacing mode and reduces the incidence of paroxysmal AFL and AF of SSS.When IHR is normal,its efficacy is apparently superior to that of abnormal IHR.更多还原