希氏束起搏与右心室心尖部起搏对心力衰竭合并心房颤动患者心脏电机械同步性及心功能的影响
Effects of His bundle pacing and right ventricular apex pacing on cardiac electrical and mechanical synchrony and cardiac function in patients with heart failure and atrial fibrillation.
作者信息
Li Yuping, Tian Huawei, Zhang Jun, Cheng Chao
机构信息
Department of Cardiology, Xiangyang No. 1 People's Hospital, Hubei University of Medicine Xiangyang, Hubei Province, China.
出版信息
Am J Transl Res. 2021 Apr 15;13(4):3294-3301. eCollection 2021.
OBJECTIVE
To investigate the effects of right ventricular apex pacing and His bundle pacing on cardiac mechanical and electrical synchrony and cardiac function in patients with heart failure and atrial fibrillation.
METHODS
A total of 72 patients with heart failure and atrial fibrillation who received permanent pacemaker implantation in our hospital were randomly divided into two groups, with 36 patients in each group. The control group received the right ventricular apex pacing, and the study group received His bundle pacing. In the two groups, the pacing parameters, cardiac function, cardiac electricity, mechanical synchrony, complications and living quality were compared.
RESULTS
During operation and 12 months after the operation, the study group's pacing threshold was higher than the pacing threshold of the control group (all P<0.001). Compared with that before the procedure, NYHA grade and LVEDD of the two groups 12 months after operation were decreased (all P<0.001), while LVEF and various quality of life scores were increased (all P<0.001). The study group's NYHA grade and LVEDD were lower than those of the control group 12 months after operation (all P<0.001), while the study group's quality of life scores and LVEF were higher than those of the control group (all P<0.001). Twelve months after operation, the study group's QRS width and IVMD were lower than QRS width and IVMD of the control group (all P<0.001). The study group's complication rate was 5.56% (2/36), which was lower than the control group's complication rate (22.22% (8/36), P<0.05).
CONCLUSION
Compared with right ventricular apical pacing, His bundle pacing in the treatment of heart failure with atrial fibrillation can better maintain the cardiac electrical and mechanical synchronization, promote the recovery of cardiac function, improve living quality, and has fewer complications and significant advantages.
目的
探讨右心室心尖部起搏与希氏束起搏对心力衰竭合并心房颤动患者心脏机械和电同步性及心功能的影响。
方法
选取我院72例接受永久性起搏器植入术的心力衰竭合并心房颤动患者，随机分为两组，每组36例。对照组采用右心室心尖部起搏，研究组采用希氏束起搏。比较两组的起搏参数、心功能、心电、机械同步性、并发症及生活质量。
结果
术中及术后12个月，研究组的起搏阈值高于对照组（均P<0.001）。与术前相比，两组术后12个月的纽约心脏病协会（NYHA）心功能分级和左心室舒张末期内径（LVEDD）均降低（均P<0.001），而左心室射血分数（LVEF）及各项生活质量评分均升高（均P<0.001）。术后12个月，研究组的NYHA心功能分级和LVEDD低于对照组（均P<0.001），而研究组的生活质量评分和LVEF高于对照组（均P<0.001）。术后12个月，研究组的QRS波宽度和室内传导时间（IVMD）低于对照组（均P<0.001）。研究组的并发症发生率为5.56%（2/36），低于对照组的并发症发生率（22.22%（8/36），P<0.05）。
结论
与右心室心尖部起搏相比，希氏束起搏治疗心力衰竭合并心房颤动能更好地维持心脏电和机械同步性，促进心功能恢复，提高生活质量，且并发症较少，具有显著优势。
Zotero 插件