【摘要】 目的 :评价双腔起搏器治疗严重缓慢性心律失常的临床疗效及价值。方法 :5 2例双腔起搏器 ,其中 41例DDD起搏器 ,11例DDDR起搏器。病态窦房结综合征 (sicksinussyndrome,SSS) 39例 ,房室传导障碍 13例 ,其中包括Ⅲ度房室传导阻滞 (thirddegreeAVblock ,Ⅲ°AVB) 3例 ,高度房室传导阻滞 (highdegreeAVblock ,HDAVB) ,Ⅱ度Ⅱ型房室传导阻滞 (typeⅡseconddegreeAVblock ,Ⅱ°Ⅱ型AVB) ,三分支传导阻滞 (threefascicularblock ,TFB)病人 ,以上病人均伴有昏厥、黑朦或严重头晕。电极植入途径为锁骨下静脉或头静脉。结果 :5 2例术后随访 1 78个月 ,临床疗效显著 ,不仅防止心博骤停发生 ,脑缺血症状消失 ,而且生活质量明显提高。 3例SSS者阵发房颤 (atrialfibrillation ,Af)术后消失 ,10例SSS者结合药物治疗Af发作次数减少。 1例扩张性心肌病死于左心衰竭。并发症 :心房感知过度 2例 ,心房感知不足 1例 ,心室电极阈值升高 1例 ,囊袋感染 1例 ,血肿 1例。结论 :双腔起搏器为较理想的生理性起搏 ,本研究证实能有效地治疗严重SSS和房室传导障碍的病人更多还原

【Abstract】 Objective:To evaluate the effect of dual-chamber pacemaker in the treatment of 52 cases severe arrhythmia among them,41 cases with DDD and 11 cases with DDDR.Methods:There were 39 cases of sick sinus syndrome (SSS) and 13 cases of A-V conduction diseases which include 3 cases of third degree AV block(Ⅲ° AVB),1 case of high degree AV block(HDAVB),5 cases of type Ⅱ second degree AV block(type Ⅱ Ⅱ° AVB),2 cases of three fascicular block (TFB),and 2 cases of complete left bundle branch block(CLBBB) .All of them precented a history of a maurosis,syncope and diszziness.Lead placement was performed through subclavian venepuncture or cephalic vein cutdown.Results:After the procedure,52 cases were followed-up with a duration of 1 to 78 months.By using DDD not only attacks of sudden death were prevented,and cerebral ischemia symptoms(syncope,presyncope,severe diszziness) disappeared,but also the quality of life was improved.Three cases of SSS with paroxysmal atrial fibrillation(Af) disappeared,and in 10 cases,attacks of Af decreased.One case of dilated cardiomyopathy died of left heart failure.Complications included 3 cases of sensitivity malfunction,1 case of threshold evlevation of LV due to fibrosis of local tissue,1 case of infection and 1 case of hematoma.Conclusion: Dual-chamber pacemake is a physiologic pacing.Our data comfirmed that it is an effective therapy in the treatment of severe SSS and A VB. [更多还原