CAJ | 학술논문

目的探讨具有自动搜索心房滞后功能的起搏器对房性心律失常近期影响，评估其临床疗效和安全性。方法选择植入Identity Adx DDD 5286型双腔起搏器病态窦房结综合征的患者43例。起搏器植入后不打开带自动搜索的心房滞后，保持起搏器出厂设置；术后3个月随访时程控为在DDD模式下打开带自动搜索的心房滞后，共随访6个月。比较起搏器植入前后及打开心房滞后模式后心房起搏百分比、动态心电图（DCG）房性心律失常发生情况。结果与术前比较术后3个月DCG 24 h房性早搏（简称房早）次数和房性心动过速（简称房速）、心房颤动（简称房颤）阵数增加（P＜0.05）；房早、房速和房颤的发作例数增加（P＜0.05）。打开具有自动搜索功能的心房滞后模式与未打开该模式比较：心房的起搏百分比明显降低[0.54（0.41，0.71）vs．0.82（0.65，0.93），P＜0.05]；DCG 24 h房早次数和房速、房颤阵数明显减少（P＜0.05）。房早、房速和房颤的发作例数减少（ P＜0.05）。结论具有自动搜索功能的心房滞后模式可以明显减少心房起搏的比例，减少房性心律失常的发生；打开具有自动搜索功能的心房滞后模式安全可靠。
목적탐토구유자동수색심방체후공능적기박기대방성심률실상근기영향，평고기림상료효화안전성。방법선택식입Identity Adx DDD 5286형쌍강기박기병태두방결종합정적환자43례。기박기식입후불타개대자동수색적심방체후，보지기박기출엄설치；술후3개월수방시정공위재DDD모식하타개대자동수색적심방체후，공수방6개월。비교기박기식입전후급타개심방체후모식후심방기박백분비、동태심전도（DCG）방성심률실상발생정황。결과여술전비교술후3개월DCG 24 h방성조박（간칭방조）차수화방성심동과속（간칭방속）、심방전동（간칭방전）진수증가（P＜0.05）；방조、방속화방전적발작례수증가（P＜0.05）。타개구유자동수색공능적심방체후모식여미타개해모식비교：심방적기박백분비명현강저[0.54（0.41，0.71）vs．0.82（0.65，0.93），P＜0.05]；DCG 24 h방조차수화방속、방전진수명현감소（P＜0.05）。방조、방속화방전적발작례수감소（ P＜0.05）。결론구유자동수색공능적심방체후모식가이명현감소심방기박적비례，감소방성심률실상적발생；타개구유자동수색공능적심방체후모식안전가고。
Objective To explore the recent influences of pacemaker with automatic search function of atrial hysteresis on atrial arrhythmias , to evaluate its clinical efficacy and safety .Methods Identity Adx DDD 5286 implanted dual chamber pacemaker for sick sinus syndrome in 43 cases.Automatic search of atrial lag was not opened with after pacemaker implantation,and the pacemaker settings was kept.Follow-up program after 3 months,DDD mode with automatic search of atrial lag was opened ,and this mods was followed up for 6 months,comparing the atrial pacing percentage and DCG atrial tachyarrhythmias of pacemaker implantation to opening atrium lag mode . Results Compared with the preoperative and operative 3 months later, DCG 24 h showed that APB and atrial tachycardia ,atrial fibrillation array number increased ( P <0.05 );APB, atrial tachycardia and atrial fibrillation episodes were increased ( P<0.05 ) .Compared with the automatic search function in atrial hysteresis model opened with and not opened:atrial pacing percentage decreased [0.54(0.41,0.71) vs.0.82(0.65,0.93),P<0.05];DCG 24 h showed that APB , atrial tachycardia , atrial fibrillation array number were decreased ( P <0.05 ) .APB, atrial tachycardia and atrial fibrillation episodes were reduced ( P<0.05 ) .Conclusions Automatic search function in atrial hysteresis model can obviously reduce the proportion of atrial pacing , reduce the occurrence of atrial arrhythmias;opened with automatic search function in atrial hysteresis model was safe and reliablely .