摘要
目的 探讨QRS波时限(QRSd)正常病态窦房结综合征患者左束支起搏后导线起搏参数、心电图及心脏超声参数.方法 前瞻性选取2019年1月至2023年1月在长沙市中医医院就诊的QRSd正常病态窦房结综合征患者100例,所有患者均行左束支起搏治疗.分析患者治疗前后起搏阈值、起搏感知、起搏阻抗、QRSd、心率、左心室舒张末内径(LVEDD)、左心室收缩末内径(LVESD)、左心室射血分数(LVEF)、左室舒张早期最大血流(E)、二尖瓣心房收缩期最大血流(A)和心肌做功指数(MPI).结果 术中及术后1周、3个月、6个月和12个月患者起搏阈值比较,差异均无统计学意义(P＞0.05);术后1周、3个月、6个月和12个月患者起搏感知均高于术中水平,而起搏阻抗低于术中水平,差异均有统计学意义(P＜0.05).术后1周、3个月、6个月和12个月患者QRSd、心率均高于术前水平,差异均有统计学意义(P＜0.05);术后1周、3个月、6个月和12个月患者的QRSd、心率比较,差异均无统计学意义(P＞0.05).术前、术后3个月、6个月及12个月LVEDD、LVESD、LVEF、E、A和MPI比较,差异均无统计学意义(P＞0.05).不同性别、年龄患者术前QRSd、心率、LVEDD、LVESD、LVEF、E、A和MPI比较,差异均无统计学意义(P＞0.05).结论 左束支起搏治疗QRSd正常病态窦房结综合征有一定的疗效,患者术后12个月内起搏参数稳定性好,心脏超声参数无明显变化.
Abstract
Objective To investigate the lead pacing parameters,electrocardiogram and cardiac ultrasound characteristics of patients with normal sick Sinoatrial node syndrome after left bundle branch pacing.Methods Prospective research methods was used,100 patients with normal sick sinoatrial node syndrome of QRSd who were treated in Changsha Traditional Chinese Medicine Hospital from January 2019 to January 20223 were selected,and all patients were treated with left bundle branch pacing.Pacing threshold,pacing sensing,pacing impedance,QRSd,heart rate,left ventricular end-diastolic diameter(LVEDD),left ventricular end-systolic diameter(LVESD),left ventricle ejection fraction(LVEF),maximum blood flow in early left ventricular diastole(E),maximum blood flow in mitral and atrial systole(A),and myocardial per-formance index(MPI)before and after treatment of patients were analyzed.Results There were no statistically significant differences in pacing thresholds between intraoperative and postoperative 1 week,3 months,6 months,and 12 months(P＞0.05).At 1 week,3 months,6 months,and 12 months after surgery,pacing perception of patients was higher than the intraoperative level,while pacing impedance of patients was lower than the intraoperative level,and the differences were statistically significant(P＜0.05).The QRSd and heart rate of patients at 1 week,3 months,6 months and 12 months after operation were higher than those before operation,and the differences were statistically significant(P＜0.05);there were no statistically significant differences in QRSd and heart rate of patients at 1 week,3 months,6 months and 12 months after op-eration(P＞0.05).There was no statistically significant difference in LVEDD,LVESD,LVEF,E,A and MPI before surgery,3 months,6 months and 12 months after surgery(P＞0.05).There was no statistically significant difference in preoperative QRSd,heart rate,LVEDD,LVESD,LVEF,E,A,and MPI among patients of different genders and ages(P＞0.05).Conclusion Left bundle branch pacing has a certain effect in the treatment of normal sick Sinoatrial node syndrome of QRSd,the pacing parameters of the patient are stable within 12 months after sur-gery,and no significant change in cardiac ultrasound parameters.
维普
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