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目的:探讨与传统心脏再同步化治疗(Bi-Ventricular Pacing Cardiac Resynchronization Therapy,Bi-V CRT)相比,左室多部位起搏(Multisite Left Ventricular Pacing,MSLV)CRT对术后起搏心电图QRS波时限及心肌复极参数的影响。方法:选取具有最新指南推荐植入心脏再同步化起搏或/和除颤器(CRT-P/CRT-D)适应症的患者。术中设定左室单部位与右室(1LV+RV)起搏和左室双部位与右室(2LV+RV)起搏。同时采集即时体表12导联心电图。分析比较2种起搏模式下患者的术后起搏心电图QRS波时限、QTc间期、JTc间期及Tp-e间期。结果:(1)共采集了21份左室单部位与右室起搏心电图,18份左室双部位与右室起搏心电图;(2)与1LV+RV相比,2LV+RV可进一步缩短术后QRS时限(△QRS:-5.57±12.52 ms vs-14.94±14.01 ms,P=0.034);(3)1LV+RV与2LV+RV比较,QTc、JTc及Tp-e时限无差异(P>0.05)。结论:与Bi-V CRT相比,MSLV CRT可进一步缩短QRS时限,但不能缩短心肌复极时间。
Objective: To investigate the effect of multisite left ventricular Pacing (MSLV) CRT on postsynaptic electrocardiogram (QRS) waveforms compared with conventional Bi-ventricular Pacing Cardiac Resynchronization Therapy (Bi-V CRT) Time limit and myocardial repolarization parameters. METHODS: Patients with the latest guidelines recommending implanted cardiac resynchronization pacing or / and defibrillator (CRT-P / CRT-D) indications were selected. During surgery, left ventricular single and right ventricular (1LV + RV) pacing and left ventricular dual and right ventricular (2LV + RV) pacing were set. Simultaneous acquisition of 12-lead ECG. The duration of QRS wave, QTc interval, JTc interval and Tp-e interval of postoperative pacing ECG were analyzed and compared in two kinds of pacing modes. Results: (1) A total of 21 LV single-site and right ventricular pacing ECG, 18 LV double-compartment and right ventricular pacing were collected; (2) Compared with 1LV + RV, 2LV + RV could be further shortened Postoperative QRS duration (△ QRS: -5.57 ± 12.52 ms vs -14.94 ± 14.01 ms, P = 0.034); (3) There was no difference in QTc, JTc and Tp-e between 1LV + RV and 2LV + 0.05). Conclusion: Compared with Bi-V CRT, MSLV CRT can further shorten the QRS time limit, but can not shorten the myocardial repolarization time.