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目的比较右室流出道(RVOT)起搏与右室心尖部(RVA)起搏对血流动力学的影响。方法 26例住院患者,9例植入双腔频率应答型起搏器(DDDR),17例植入心室按需起搏器或频率应答型心室按需起搏器(VVI或VVIR)。用Swan-Ganz漂浮导管分别测定血流动力学指标。结果 26例患者全部在RVOT成功植入螺旋电极。与RVA起搏比较,RVOT起搏的每分输出量(CO)、心脏指数(CI)、每搏量(SV)、每搏指数(SVI)均明显增加(P<0.05)。感知、起搏阈值、心室阻抗等起搏参数两者无明显差别;术后随访6~30个月,未见电极脱位。结论采用螺旋电极行RVOT起搏,血流动力学指标优于传统的RVA起搏。
Objective To compare hemodynamic effects of right ventricular apex (RVA) pacing with right ventricular outflow tract (RVOT) pacing. Methods Twenty - six inpatients were enrolled. Nine patients underwent dual - lumen frequency response pacemaker (DDDR) and 17 patients underwent ventricular pacemaker or frequency response ventricular - on - demand pacemaker (VVI or VVIR). Swan-Ganz floating catheter were used to measure hemodynamic parameters. Results All 26 patients were successfully implanted with helical electrodes in RVOT. Compared with RVA, the COOT, CI, SV and SVI in RVOT pacing increased significantly (P <0.05). Perception, pacing threshold, ventricular impedance parameters such as pacing no significant difference between the two; postoperative follow-up 6 to 30 months, no electrode dislocation. CONCLUSIONS: RVOT pacing with spiral electrodes is superior to conventional RVA pacing in hemodynamic parameters.