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目的判定右室心尖部起搏(RVAP)对心功能正常的患者心室重构以及临床和功能参数的影响。方法选取75例由于完全性房室传导阻滞(CAVB)而行起搏器植入的患者,其中男58例,女17例,平均(70.9±14)岁。超声心动图检查左室射血分数(LVEF)、左室舒张末期内径(LVEDD)。分析以下参数:基础心脏病、NYHA心功能分级、心室刺激时间、QRS间期。结果两次比较的观测平均观察时间为60.2个月。起搏器植入前,平均LVEF为72%,LVEDD为46mm;植入后,平均LVEF为69.7%(P=0.0025),平均LVEDD为48.5mm(P=0.0001);植入后平均QRS间期为156ms。仅有4例患者观察到心室重构(5.3%)。结论右室心尖部起搏患者长期随访结果,观察到心室重构现象较低,其它相关指标改变无统计学意义。
Objective To determine the effect of right ventricular apical pacing (RVAP) on ventricular remodeling and clinical and functional parameters in patients with normal cardiac function. Methods Seventy-five patients undergoing pacemaker implantation due to complete atrioventricular block (CAVB) were enrolled. Among them, 58 were male and 17 were female, with an average of (70.9 ± 14) years. Echocardiography left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEDD). The following parameters were analyzed: basal heart disease, NYHA functional class, ventricular stimulation time, QRS interval. Results The average observation time of two comparisons was 60.2 months. Before implantation, the average LVEF was 72% and the LVEDD was 46 mm. After implantation, the average LVEF was 69.7% (P = 0.0025) and the average LVEDD was 48.5 mm (P = 0.0001) For 156ms. Ventricular remodeling was observed in only 4 patients (5.3%). Conclusions The results of long-term follow-up of patients with right ventricular apex pacing showed that ventricular remodeling was observed with no significant change in other related parameters.