Gammage M, Schofield S, Rankin I, Bennett M, Coles P, Pentecost B
Department of Cardiology, General Hospital, Birmingham, United Kingdom.
Pacing Clin Electrophysiol. 1991 Feb;14(2 Pt 1):174-80. doi: 10.1111/j.1540-8159.1991.tb05087.x.
In order to assess the value of a simple, single setting rate response option to VVI pacing, 12 patients (mean age 75.1 +/- 6.2, range 62-83 years, seven males, five females) with symptomatic complete heart block were entered into a double-blind, randomized crossover trial of VVI versus VVIR (single setting rate responsive) pacing using Medtronic Activitrax pacemakers. Assessment was by time taken in seconds (sec) and Borg scale symptom score (6-20) for simple activities (standing from chair x 30; walking 800 meters; 52 steps on stairs [slow and fast pace], and incremental, noninclined maximal treadmill exercise), performed after a 4-week period with the patient in each pacing mode. Times were significantly improved in VVIR mode for standing from chair [mean +/- SD] (78.7 +/- 22.5 vs 70.7 +/- 19.5 sec; P less than 0.05), for 800 m walk (1032 +/- 80 vs 885 +/- 59 sec; P less than 0.05), fast ascent of stairs (29.5 +/- 7.7 vs 26.5 +/- 5.6 sec; P less than 0.02), and treadmill exercise (626.7 +/- 189.5 vs 741.0 +/- 170.2 sec, P less than 0.005) although no difference in time for slow stair ascent was demonstrated. Symptom scores were significantly less in VVIR for standing from chair (12.7 +/- 2.8 vs 10.3 +/- 1.8; P less than 0.01), 800 m walk (10.9 +/- 2.7 vs 9.0 +/- 2.4; P less than 0.01), slow ascent of stairs (11.6 +/- 2.1 vs 10.0 +/- 2.0; P less than 0.01), and fast ascent of stairs (13.0 +/- 2.0 vs 11.7 +/- 1.9; P less than 0.02) but unchanged for treadmill exercise.(ABSTRACT TRUNCATED AT 250 WORDS)
为了评估VVI起搏的一种简单、单设置频率应答选项的价值，12例有症状的完全性心脏传导阻滞患者（平均年龄75.1±6.2岁，范围62 - 83岁，男性7例，女性5例）使用美敦力Activitrax起搏器进入VVI与VVIR（单设置频率应答）起搏的双盲、随机交叉试验。评估通过简单活动（从椅子上站起来30次；步行800米；上楼梯52级[慢步和快步]，以及递增、非倾斜最大跑步机运动）所需的时间（秒）和Borg量表症状评分（6 - 20）进行，在患者处于每种起搏模式4周后进行这些活动。在VVIR模式下，从椅子上站起来的时间[均值±标准差]显著改善（78.7±22.5 vs 70.7±19.5秒；P<0.05），800米步行时间（1032±80 vs 885±59秒；P<0.05），快速上楼梯时间（29.5±7.7 vs 26.5±5.6秒；P<0.02），以及跑步机运动时间（626.7±189.5 vs 741.0±170.2秒，P<0.005），尽管慢步上楼梯时间无差异。在VVIR模式下，从椅子上站起来、800米步行、慢步上楼梯和快速上楼梯的症状评分显著更低（分别为12.7±2.8 vs 10.3±1.8；P<0.01；10.9±2.7 vs 9.0±2.4；P<0.01；11.6±2.1 vs 10.0±2.0；P<0.01；13.0±2.0 vs 11.7±1.9；P<0.02），但跑步机运动的症状评分无变化。（摘要截短至250字）
