中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2013年
6期
427-430
,共4页
汪菁峰%宿燕岗%秦胜梅%崔洁%陈海燕%葛均波
汪菁峰%宿燕崗%秦勝梅%崔潔%陳海燕%葛均波
왕정봉%숙연강%진성매%최길%진해연%갈균파
心脏再同步治疗%右心室导线%心室导线间距%心力衰竭
心髒再同步治療%右心室導線%心室導線間距%心力衰竭
심장재동보치료%우심실도선%심실도선간거%심력쇠갈
Cardiac resynchronization therapy%Right ventricular lead%Interlead distance%Heart failure
目的 探讨右心室起搏部位改变时,左、右心室导线间距对心脏再同步治疗(CRT)即刻疗效的影响.方法 对25例符合适应证患者行CRT手术,术中将左心室导线植入侧壁或侧后壁,先后将右心室导线植入右心室流出道和右心室心尖部,分别测得主动脉速度血流积分及心肌收缩达峰时间标准差,同时比较此2种不同部位左、右心室导线间距,包括直接、垂直和水平距离(分别由正位及左侧位投影时测得)的差异.结果 右心室心尖部起搏主动脉速度血流积分显著高于右心室流出道起搏[(15.76±2.29) cm对(14.71±2.12) cm,P＜0.001],QRS时限则显著较窄[(141.84±20.89) ms对(159.84±19.56) ms,P＜0.001].右心室心尖部起搏侧位投影下的导线间距(校正后)显著大于右心室流出道起搏[(161.23±44.58) mm对(121.34±55.91) mm,P＜0.001],其垂直距离(校正后)亦显著大于后者[(97.65±45.73) mm对(39.41±23.51) mm,P＜0.001].结论 CRT术中改变右心室起搏部位时,侧位投影下的左、右心室导线间距较大者CRT手术即刻反应较佳.
目的 探討右心室起搏部位改變時,左、右心室導線間距對心髒再同步治療(CRT)即刻療效的影響.方法 對25例符閤適應證患者行CRT手術,術中將左心室導線植入側壁或側後壁,先後將右心室導線植入右心室流齣道和右心室心尖部,分彆測得主動脈速度血流積分及心肌收縮達峰時間標準差,同時比較此2種不同部位左、右心室導線間距,包括直接、垂直和水平距離(分彆由正位及左側位投影時測得)的差異.結果 右心室心尖部起搏主動脈速度血流積分顯著高于右心室流齣道起搏[(15.76±2.29) cm對(14.71±2.12) cm,P＜0.001],QRS時限則顯著較窄[(141.84±20.89) ms對(159.84±19.56) ms,P＜0.001].右心室心尖部起搏側位投影下的導線間距(校正後)顯著大于右心室流齣道起搏[(161.23±44.58) mm對(121.34±55.91) mm,P＜0.001],其垂直距離(校正後)亦顯著大于後者[(97.65±45.73) mm對(39.41±23.51) mm,P＜0.001].結論 CRT術中改變右心室起搏部位時,側位投影下的左、右心室導線間距較大者CRT手術即刻反應較佳.
목적 탐토우심실기박부위개변시,좌、우심실도선간거대심장재동보치료(CRT)즉각료효적영향.방법 대25례부합괄응증환자행CRT수술,술중장좌심실도선식입측벽혹측후벽,선후장우심실도선식입우심실류출도화우심실심첨부,분별측득주동맥속도혈류적분급심기수축체봉시간표준차,동시비교차2충불동부위좌、우심실도선간거,포괄직접、수직화수평거리(분별유정위급좌측위투영시측득)적차이.결과 우심실심첨부기박주동맥속도혈류적분현저고우우심실류출도기박[(15.76±2.29) cm대(14.71±2.12) cm,P＜0.001],QRS시한칙현저교착[(141.84±20.89) ms대(159.84±19.56) ms,P＜0.001].우심실심첨부기박측위투영하적도선간거(교정후)현저대우우심실류출도기박[(161.23±44.58) mm대(121.34±55.91) mm,P＜0.001],기수직거리(교정후)역현저대우후자[(97.65±45.73) mm대(39.41±23.51) mm,P＜0.001].결론 CRT술중개변우심실기박부위시,측위투영하적좌、우심실도선간거교대자CRT수술즉각반응교가.
Objective To evaluate the relationship between interlead distance and acute response to cardiac resynchronization therapy (CRT) when right ventricular (RV) pacing site alters.Methods A total of 25 consecutive patients underwent CRT for standard indications.Left ventricular (LV) lead was placed at the lateral or posterolateral wall.RV pacing site altered from RV outflow tract (RVOT)to RV apex (RVA)in the course of implantation.Aortic velocity time integral(aVTI) and standard deviation for time to peak velocity(TsSD) were assessed during operation.A comparison was also made as for the LV-RV interlead distance,including its vertical and horizontal components,on the posteroanterior and left lateral fluoroscopy views respectively.Results Compared with RVOT pacing,a significantly higher aVTI [(15.76±2.29) cm vs.(14.71±2.12) cm,P＜0.001] and narrower QRSd[(141.84±20.89) ms vs.(159.84± 19.56) ms,P＜0.001] could be obtained with RVA pacing.A significantly larger direct interlead distance(which had been corrected)on the lateral fluoroscopy view could also be observed with RVA pacing in comparison with RVOT pacing[(161.23±44.58) mm vs.(121.34±55.91) mm,P＜0.001],so did the corrected vertical interlead distance[(97.65±45.73) mm vs.(39.41±23.51) mm,P＜0.001].Conclusion A larger LV-RV interlead distance on lateral fluoroscopy view can result in better immediate response to CRT when RV lead position altered in the course of implantation.
