Hemayat Sevil, Shafiee Akbar, Oraii Saeed, Roshanali Farideh, Alaedini Farshid, Aldoboni Amirhossein Sami
Faculty of Medicine, Islamic Azad University, Tehran, Iran.
J Interv Card Electrophysiol. 2014 Jun;40(1):81-6. doi: 10.1007/s10840-014-9878-y. Epub 2014 Mar 14.
This study aimed at comparing the development of tricuspid and mitral regurgitation between the right ventricular outflow tract (RVOT) and right ventricular apex (RVA) pacing.
We prospectively enrolled 164 patients for permanent pacemaker implantation due to sick sinus syndrome or atrioventricular block and randomly divided them into two equal groups to receive either RVOT or RVA pacing. Patients with heart failure or valvular disease were excluded. The post-procedural echocardiographic evaluations were performed 1 year after the pre-procedural echocardiography, and the results were compared with respect to the development of mitral and tricuspid regurgitation and probable changes in the ejection fraction (EF).
Age, gender, pacing mode, and baseline cardiac rhythm did not significantly differ between the RVOT and RVA pacing groups. The incidence of mitral regurgitation was significantly higher in the RVA group (p = 0.03), but the incidence of tricuspid regurgitation was similar in both groups. There was a trend toward less tricuspid regurgitation in the RVOT group; however, it was not statistically significant. The mean EF was not significantly different between the study groups.
It seems that the incidence of mitral regurgitation in RVA pacing is significantly higher than that in RVOT pacing. The formation of tricuspid regurgitation needs to be discussed in the future.
IRCT201103146061N1.
本研究旨在比较右心室流出道（RVOT）起搏与右心室心尖部（RVA）起搏时三尖瓣和二尖瓣反流的发展情况。
我们前瞻性纳入了164例因病态窦房结综合征或房室传导阻滞而行永久性起搏器植入术的患者，并将他们随机分为两组，每组人数相等，分别接受RVOT起搏或RVA起搏。排除患有心力衰竭或瓣膜疾病的患者。在术前超声心动图检查1年后进行术后超声心动图评估，并比较二尖瓣和三尖瓣反流的发展情况以及射血分数（EF）的可能变化。
RVOT起搏组和RVA起搏组在年龄、性别、起搏模式和基线心律方面无显著差异。RVA组二尖瓣反流的发生率显著更高（p = 0.03），但两组三尖瓣反流的发生率相似。RVOT组有三尖瓣反流较少的趋势；然而，差异无统计学意义。研究组之间的平均EF无显著差异。
似乎RVA起搏时二尖瓣反流的发生率显著高于RVOT起搏。三尖瓣反流的形成有待未来进一步探讨。
IRCT201103146061N1。
