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目的:观察并比较VVI单腔起搏器植入右心室间隔部和右心室心尖部对心动过缓患者术后心脏电机械同步性及血清脑钠肽的影响。方法:心房颤动伴房室传导阻滞及心动过缓需植入VVI单腔起搏器患者23例,右心室间隔部起搏患者11例为治疗组,同时行右心室心尖部起搏患者12例为对照组,观察并比较2组手术时间、起搏参数、QRS波宽度,和起搏器植入术前、后血清脑钠肽水平的变化。结果:2组手术时间、QRS波宽度比较差异有统计学意义(P<0.05);起搏阈值、感知阈值、电极阻抗比较差异均无统计学意义(P>0.05);随访6个月时对照组较治疗组血清脑钠肽水平增加(P<0.05)。结论:与传统植入部位右心室心尖部起搏相比,右心室间隔部起搏更接近生理情况,能更好地维持患者的心脏电机械同步性,对血流动力学影响更小。
OBJECTIVE: To observe and compare the effects of VVI single chamber pacemaker implantation on right ventricular septum and right ventricular apex on postoperative cardiac electrical synchronization and serum brain natriuretic peptide in patients with bradycardia. Methods: Atrial fibrillation with atrioventricular block and bradycardia were implanted in patients with VVI single chamber pacemaker in 23 patients, right ventricular septal pacing in 11 patients for the treatment group, while the right ventricular apical pacing patients 12 For the control group, the changes of serum brain natriuretic peptide levels were observed and compared in two groups after operation time, pacing parameters, QRS wave width, and pacemaker implantation. Results: There was significant difference in QRS wave width between the two groups (P <0.05). There was no significant difference in pacing threshold, perceptual threshold and electrode impedance between the two groups (P> 0.05) The level of serum brain natriuretic peptide in treatment group was higher than that in treatment group (P <0.05). Conclusion: Compared with the right ventricular apical pacing in the traditional implantation site, the right ventricular septal pacing is closer to the physiological condition, which can better maintain the patient’s cardiac electromechanical synchronization and have less influence on the hemodynamics.