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目的:评价VVI模式下右室间隔部起搏和右室心尖部起搏1年后对左室收缩同步性的影响。方法:选择60例只能接受VVI单腔起搏治疗且起搏依赖的患者,分为右室间隔部起搏组(RVSP组,n=30例),和右室心尖部起搏组(RVAP组,n=30例)。于术前及术后1年测定左室射血分数(LVEF),同时应用实时三维超声心动图技术获取实时三维超声心动图时间-容积曲线,评价左室收缩同步性。结果:术前两组左室收缩的同步性及LVEF无显著差异;随访1年后,RVSP组与RVAP组相比,LVEF稍有提高,但无统计学差异(P>0.05),左室收缩同步性指标Tmsv 16-SD%、Tmsv 12-SD%明显下降,差异有统计学意义(P<0.05)。结论:RVSP较RVAP左室收缩的同步性好,左室收缩功能影响小,更接近于生理起搏。
OBJECTIVE: To evaluate the effect of RVG pacing and right ventricular apex pacing on left ventricular systolic synchrony in VVI mode. Methods: Sixty patients with pacing-dependent VVI single-chamber pacing were selected and divided into right ventricular septal pacing group (RVSP group, n = 30) and right ventricular apical pacing group (RVAP Group, n = 30). Left ventricular ejection fraction (LVEF) was measured preoperatively and 1 year after operation. Real-time three-dimensional echocardiography was used to acquire real-time three-dimensional echocardiography time-volume curve to evaluate left ventricular systolic synchrony. Results: There was no significant difference in left ventricular systolic synchrony and LVEF between preoperative two groups. After 1 year follow-up, LVEF slightly increased in RVSP group compared with RVAP group, but there was no significant difference (P> 0.05) Synchronous indicators Tmsv 16-SD%, Tmsv 12-SD% decreased significantly, the difference was statistically significant (P <0.05). CONCLUSIONS: RVSP has better synchrony than RVAP left ventricular systolic function, little effect of left ventricular systolic function, and closer to physiological pacing.