本文選題：起搏器　切入點：人工　出處：《中國醫(yī)學(xué)影像技術(shù)》2015年09期

【摘要】：目的采用實時三維超聲心動圖(RT-3DE)評價右心室心尖部(RVA)和間隔部(RVS)起搏對緩慢性心律失�；颊咦笮姆客叫缘挠绊�。方法將51例高度或Ⅲ度房室傳導(dǎo)阻滯患者分為RVA組(n=31)和RVS組(n=20),采用RT-3DE分別測算患者安置埋藏式心臟起搏器術(shù)前和術(shù)后1、3、6、12個月的左心房主動射血分數(shù)(LAAEF)、左心室射血分數(shù)(LVEF)及左心房16節(jié)段、12節(jié)段、6節(jié)段QRS波起點到左心房收縮最小收縮容積的時間標準差(Tmsv-16-SD、Tmsv-12-SD、Tmsv-6-SD)及最大時間差(Tmsv-16-Dif、Tmsv-12-Dif、Tmsv-6-Dif)的變化。并對以上參數(shù)進行統(tǒng)計學(xué)分析。結(jié)果兩組術(shù)后3、6、12個月的Tmsv-16-SD、Tmsv-12-SD及Tmsv-6-SD和兩組術(shù)后各時間點的Tmsv-16-Dif、Tmsv-12-Dif、Tmsv-6-Dif均分別較各組術(shù)前增高(P均0.05),RVS組術(shù)后3、6、12個月Tmsv-16-SD、Tmsv-12-SD、Tmsv-6-SD和Tmsv-16-Dif、Tmsv-12-Dif、Tmsv-6-Dif均小于同時點RVA組(P0.05)。RVS組6、12個月的LAAEF、LVEF均大于同時點RVA組(P0.05)。結(jié)論采用RT-3DE檢測的左心房各節(jié)段達最小容積的最大時間差可較時間標準差更敏感地評價右心室不同部位起搏對左心房同步性的影響。持續(xù)RVA和RVS起搏均可導(dǎo)致緩慢性心律失�；颊咦笮姆渴湛s運動失同步化,但RVS起搏的不良影響較小。
[Abstract]:Objective to evaluate the effects of RVA (right ventricular apex) and RVS (septal) pacing on synchronism of left atrium in patients with bradyarrhythmia by real-time three-dimensional echocardiography (RT-3DED). Methods 51 patients with high or third degree atrioventricular block were divided into two groups. The left atrial active ejection fraction (LAAEFF, left ventricular ejection fraction (LVEF) and left ventricular ejection fraction (LVEF) were measured by RT-3DE before and after implantation of implantable pacemaker in RVA group and RVS group, respectively. The starting point of QRS wave in 12 segments and 12 segments of left atrium were measured by RT-3DE. The time standard deviation to the minimum systolic volume of left atrium Tmsv-16-SDTmsv-12-SDTmsv-6-SD1) and the maximum time difference (Tmsv-16-DifMr Tmsv-12-DifMr Tmsv-6-Dif) were analyzed statistically. Results the mean scores of Tmsv-16-SDV Tmsv-12-Difv-12-DifTmsv-6-Dif and Tmsv-16-SDV Tmsv-12-DifTmsv-6-Dif were obtained in the two groups after operation. The levels of Tmsv-16-SDV Tmsv-6-SD and Tmsv-16-DifTmsv-6-SD and Tmsv-16-DifTmsv-6-Dif were lower than those of RVA group (P 0.05. RVS) at 12 months. Conclusion the maximum time difference of minimum volume of left atrial segment measured by RT-3DE is higher than that of RVA group at 12 months. The effects of pacing in different parts of right ventricle on left atrial synchrony were evaluated more sensitively than time standard deviations. Continuous RVA and RVS pacing could lead to the loss of synchronization of left atrial contraction in patients with bradyarrhythmia. However, the adverse effects of RVS pacing were small.
【作者單位】： 貴州省人民醫(yī)院心內(nèi)科;
【基金】：貴州省優(yōu)秀科技教育人才省長資金(2012-12) 貴州省衛(wèi)生計生委科學(xué)技術(shù)基金(GZWKJ2014-1-047)
【分類號】：R540.45

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