CAJ | 학술논문

目的：探讨右室流出道（RVOT）和右室心尖部（RVA）起搏时心电图心肌复极标志的变化及不同起搏方式对心肌复极离散度的影响。方法：选取我院因三度房室传导阻滞安装DDD起搏器的患者68例，将心室电极分别置于RV O T或RV A ，术前及术后1周观测体表心电图的Q RS时限、QTc间期、Tp-ec间期和Tp-e/QT。结果：术后两组QRS时限、QTc 、Tp-ec间期及Tp-e/QT比值较术前均延长，且RVA组较 RVOT 组延长显著（P＜0．05）。结论：与RVA 起搏比较，RVOT起搏对心电同步性及心肌复极离散度、跨壁复极离散度（TDR）影响较小。
목적：탐토우실류출도（RVOT）화우실심첨부（RVA）기박시심전도심기복겁표지적변화급불동기박방식대심기복겁리산도적영향。방법：선취아원인삼도방실전도조체안장DDD기박기적환자68례，장심실전겁분별치우RV O T혹RV A ，술전급술후1주관측체표심전도적Q RS시한、QTc간기、Tp-ec간기화Tp-e/QT。결과：술후량조QRS시한、QTc 、Tp-ec간기급Tp-e/QT비치교술전균연장，차RVA조교 RVOT 조연장현저（P＜0．05）。결론：여RVA 기박비교，RVOT기박대심전동보성급심기복겁리산도、과벽복겁리산도（TDR）영향교소。
Objective:This study is aimed to observe the effect of right ventricular outflow tract (RVOT) and right ventricular apical(RVA) pacing on the dispersion of myocardial repolarization .Methods :68 patients with complete atrioventricular block were selected ,who were implanted with DDD pacemakers .They were divided into RVOT pacing group(n= 34) or RVA pacing group (n=34) .Standard surface ECGs were recorded before and after the operation to implant the pacemaker .The parameters of repolarization dispersion included QRS duration ,QTc in-terval ,Tp-ec interval ,and Tp-e/QT ratio .Results:Post-operation QRS duration ,QTc interval ,Tp-ec interval and Tp-e/QT ratio were all prolonged in the both group ;these parameters were significantly longer in the RVA group than the RVOT group (P <0 .05) .Conclusion:Compared with RVA pacing ,RVOT pacing shows benefit effect in e-lectrical synchronization ,myocardial dispersion of repolarization and transmural dispersion of repolarization .