Romero L R, Haffajee C I, Levin W, Doherty P W, Berkovits B V, Alpert J S
Pacing Clin Electrophysiol. 1984 Jan;7(1):10-7. doi: 10.1111/j.1540-8159.1984.tb04852.x.
Thirteen patients who all had previously inserted temporary or permanent pacemakers (6, VVI; 7, A-V sequential) were studied by two-dimensional echocardiography and radionuclide gated blood pool ventriculography (RVG) for non-invasive evaluation of cardiac performance. Patients were paced in both the VVI mode and during sinus/atrial or A-V sequential pacing. Although there was no objective change of the ejection fraction during V-pacing and atrial/A-V sequential pacing or sinus rhythm, as has been previously reported, A-V sequential pacing did result in significant improvement in overall cardiac function and output as judged by radionuclide ventriculography and blood pressure response in most of our patients. An appropriately timed atrial contribution to ventricular systole resulted in improved ventricular function in those individuals with pre-existing systolic or diastolic myocardial dysfunction and/or sick sinus syndrome in whom pacemaker therapy was indicated. Radionuclide ventriculography appears to be a reliable, accurate, non-invasive method that can be used to evaluate patients before implantation of a permanent ventricular or atrioventricular pacemaker in order to decide which pacing mode is best for that particular individual.
对13名先前已植入临时或永久起搏器的患者（6名VVI型；7名房室顺序型）进行了二维超声心动图和放射性核素门控心血池心室造影（RVG）检查，以对心脏功能进行无创评估。患者分别在VVI模式以及窦性/心房或房室顺序起搏时接受起搏。尽管如先前报道的那样，在心室起搏、心房/房室顺序起搏或窦性心律期间射血分数没有客观变化，但根据放射性核素心室造影和血压反应判断，在我们的大多数患者中，房室顺序起搏确实使整体心脏功能和心输出量有显著改善。对于那些已有收缩或舒张期心肌功能障碍和/或病态窦房结综合征且有起搏治疗指征的个体，适时的心房对心室收缩的贡献可改善心室功能。放射性核素心室造影似乎是一种可靠、准确的无创方法，可用于在植入永久性心室或房室起搏器之前评估患者，以确定哪种起搏模式最适合该特定个体。
