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目的 观察右心室双部位起搏治疗心力衰竭的临床效果 ,探讨不同的起搏部位对血流动力学的即刻影响及右心室双部位起搏后近期心功能的影响。方法 患者 6例 ,其中男性 4例 ,女性 2例。诊断扩张型心肌病 1例 ,缺血性心肌病 5例。心房颤动伴完全性左束支传导阻滞 ,QRS波时限 (167± 2 0 )ms ,心功能Ⅱ～Ⅳ级。置入右心室心尖部及流出道二根起搏电极 ,连接于全自动双腔起搏 (DDD)起搏器。结果 安置起搏器术后即刻采用右心室双部位起搏血流动力学参数优于单纯右心室心尖部及右心室流出道起搏 ,随访 3个月、6个月、12个月 ,右心室双部位起搏心功能均有改善。结论 初步临床观察提示右心室双部位起搏治疗心力衰竭有效。
Objective To observe the clinical effect of double ventricular pacing in treating right heart failure (CHF) and to investigate the immediate effect of different pacing sites on hemodynamics and the recent cardiac function after double-pacing right ventricle. Methods Six patients, including 4 males and 2 females. Diagnosis of dilated cardiomyopathy in 1 case, 5 cases of ischemic cardiomyopathy. Atrial fibrillation with complete left bundle branch block, QRS wave duration (167 ± 20) ms, cardiac function Ⅱ ~ Ⅳ level. Into the right ventricular apical and outflow tract two pacing electrodes, connected to the automatic dual-chamber pacemaker (DDD) pacemaker. Results The right ventricular bi-directional pacing hemodynamic parameters were better than the right ventricular apical and right ventricular outflow tract pacing immediately after placement of pacemaker. The patients were followed up for 3 months, 6 months, 12 months, right ventricular Pacemaker cardiac function improved. Conclusion Preliminary clinical observations suggest that double-pacing right ventricle is effective in treating heart failure.