|
|
|
| Effects of Right Ventricular Septum Pacing on Cardiac Function |
| WANG Yaling, et al |
| The Second Hospital of Hebei Medical University, Hebei Shijiazhuang 050000, China |
|
|
|
|
Abstract Objective: To study and compare the effects of right ventricular middle septum pacing and right ventricular high septum pacing on cardiac function. Methods: From January 2018 to March 2020, 100 patients with complete atrioventricular block undergoing permanent pacemaker implantation in our hospital were included in the study, and were divided into 2 groups with 50 patients in each according to the random number table method. Group A was pacing at the high septum of right ventricle, while group B was pacing at the middle septum of right ventricle. The levels of n-terminal brain natriuretic peptide (NT-proBNP), cardiac color Doppler monitoring index, QRS wave time limit, quality of life score and incidence of adverse cardiac events were compared between the two groups. Results: The levels of NT-proBNP in both groups were significantly lower than those before operation at 3 and 6 months after operation (P<0.05), while the levels of NT-proBNP in Group B were lower than those in Group A at 3 and 6 months after operation (P<0.05). The LVEF, LVEDD, LVESD and LAEF at 3 and 6 months after operation were significantly improved in both groups (P<0.05), while the LVEF and LAEF in group B were higher than those in group a (P<0.05), while the LVEDD and LVESD in group B were lower than those in control group (P<0.05). The QRS wave duration of the two groups at 3 months and 6 months after operation was significantly shorter than that before operation (P<0.05), while the QRS wave duration of Group B was shorter than that of Group A at 3 months and 6 months after operation (P<0.05). The quality of life scores of both groups at 3 and 6 months after operation were significantly lower than those before operation (P<0.05), while the quality of life scores of Group B were lower than those of Group A at 3 and 6 months after operation (P<0.05). Within 6 months after operation, the incidence of adverse cardiac events in group A was 8.00%, while that in group B was 4.00%. There was no significant difference between the two groups (P>0.05). Conclusion: Pacing in the middle septum of right ventricle can improve the cardiac function of patients with permanent pacemaker implantation, which is better than pacing in the high septum of right ventricle, and the risk of adverse cardiac events is not increased, which verifies it’s safety and reliability.
|
|
|
|
|
|
[1] Joshua M,Lader Chirag R,Barbhaiya Kishore Subnani,et al.Factors predicting persistence of AV nodal block in post-TAVR patients following permanent pacemaker implantation[J].Pacing and Clinical Electrophysiology,2019,42(10):1347~1354.
[2] Hussam Ali,Pierpaolo Lupo,Sara Foresti,et al.Nearly fatal ventricular arrhythmia following pacemaker implantation in a young female with complete heart block[J].Journal of Arrhythmia,2019,35(5):766~769.
[3] Garima,Choudhary Rashmi,Syal Rakesh,Kumar,et al.Anaesthetic management of pacemaker implantation in a child with dilated cardiomyopathy and acquired complete atrioventricular heart block[J].Indian Journal of Anaesthesia,2019,63(11):938~940.
[4] 谢上才,王迎,江力勤,等.右心室心尖部与高位间隔部起搏对心功能长期影响[J].心脑血管病防治,2017,17(4):288~290.
[5] 朱琳,侯爱军,刘刚,等.右室不同部位起搏对患者心功能及心理状态的影响[J].中国心血管病研究,2017,15(10):908~912.
[6] 奚悦文,范维琥.明尼苏达心力衰竭生活质量调查表适用性的评价[J].上海医学,2004,27(4):15~18.
[7] 干艳捷,田少江.心室再同步化治疗右室不同部位起搏对慢性心力衰竭病人心功能的影响[J].中西医结合心脑血管病杂志,2017,15(1):88~90.
[8] Rachel M.Kaplan,Ajay Yadlapati,Eric P.Cantey,et al.Conduction recovery following pacemaker implantation after transcatheter aortic valve replacement[J].Pacing and Clinical Electrophysiology,2019,42(2):146~152.
[9] Dasselaar,Kosse J,Knops,Reinoud E,Tjong,Fleur V Y,et al.Leadless pacemaker implantation after explantation of infected conventional pacemaker systems:a viable solution[J].Heart rhythm:the official journal of the Heart Rhythm Society,2019,16(1):66~71.
[10] 王敬祥.倍他乐克联合起搏器治疗缓室率心衰的临床效果观察[J].中国实用医药,2016,11(16):20,202
[11] Matthew R Russell,Roberto Galloti,Jeremy P Moore.Initial experience with transcatheter pacemaker implantation for adults with congenital heart disease[J].Journal of Cardiovascular Electrophysiology,2019,30(8):1362~1366.
[12] Stephen Cresse,Trevor Eisenberg,Carlos Alfonso,et al.Cardiac conduction abnormalities associated with pacemaker implantation after transcatheter aortic valve replacement[J].Pacing and Clinical Electrophysiology,2019,42(7):846~852.
[13] 倪水清,贺集贤,王建平,等.不同心脏起搏方式对心力衰竭伴心房颤动患者心衰指标、心功能的影响及经济效益分析[J].成都医学院学报,2020,15(2):251~255.
[14] 彭思亮,王志荣,陈文苏,等.右室间隔不同部位起搏对术后QRS波时限和振幅及心功能的影响[J].徐州医科大学学报,2018,38(2):77~81.
[15] 魏婕.右室中位间隔部起搏对Ⅲ度房室传导阻滞病人左心功能及心脏血流动力学的影响[J].中西医结合心脑血管病杂志,2019,17(17):2671~2674. |
|
|
|
2021, Vol. 27 
