许国卿 梁延春 于海波 王祖禄 韩雅玲 王冬梅.起搏器术后新发房性心律失常的影响因素分析[J].现代生物医学进展英文版,2015,15(6):1084-1088. |
起搏器术后新发房性心律失常的影响因素分析 |
Analysis of the Influencing Factors of Atrial Arrhythmia after CardiacPermanent Pacemaker Implantation |
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DOI: |
中文关键词: 永久起搏器 房性心律失常 心房颤动 |
英文关键词: Permanent pacemaker Atrial arrhythmia Atrial fibrillation |
基金项目:全军医疗卫生科技(06MB049) |
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中文摘要: |
目的: 探讨起搏器术后新发房性心律失常的发生情况及其相关影响因 素。 方法: 选择 2006 年 1 月 至 2007 年 12 月 于沈阳军
区总医院首次植入永久起搏器的 107 例 患者, 男 性 50 例 , 平均年龄 65.0± 1 1.9 岁 , 术前通过追问 病史及相关检查均排除房性心
律失常(房颤、房扑、房速),术后平均随访 3.9 年,观察新发房性心律失常情况。 按术后是否出现房性心律失常,将患者分为 新发房
性心律失常组和无房性心律失常组, 比较两组患者术前和术后心脏超声 结果的变化、心室起搏比例、起搏部位及起搏模式, 并通
过 logistic 回归分析起搏器术后发生房性心律失常的影响因 素。 结果: 新发房性心律失常组 26 例 (24.3 %), 其中房颤 17 例 (1 5.9
%), 房扑 2 例 (1.9 %), 房速 7 例 (6.5 %);无房性心律失常组 81 例。 与 无房性心律失常组比较, 新发房性心律失常组左房内 径明 显
增加(P=0.040)、二尖瓣返流程度较重(P=0.032)及左室射血分数明 显下降(P=0.001), 心室起搏百分比(VP%)显著升高 (P=0.01 7)。 心
尖部起搏患者房性心律失常的发生率明 显高于间 隔部起搏(33.3% vs 1 6.9%, P<0.05), 双腔起搏组患者房性心律失常发生率明 显
低于单腔起搏器组 (1 8.7% vs 37.5%, P<0.05)。 Logistic 回归 分析显示术后新发房性心律失常的 发生与 高比例 的 心室起搏(P=0.
006)、 VVI(R)起搏模式(P=0.01 4)及右心室起搏电极导线植于心尖部(P=0.024)显著相关。 结论: 起搏模式、心室起搏百分比、起搏部
位是起搏器术后发生房性心律失常的影响因 素。 |
英文摘要: |
Objective:To evaluate the incidence and related influencing factors of atrial arrhythmia in patients after cardiac
permanent pacemaker implantation.Methods:1 07 cases underwent cardiac pacemaker therapy for the first time in General Hospital of
Shenyang Military Command from January 2006 to December 2007 were enrolled in this study (male: 50, mean age: 65.0± 1 1.9 years).
These patients who had atrial arrhythmia (atrial fibrillation, atrial flutter, atrial tachycardia) before implantation were excluded by
learning the history and examination. According to whether the patients had postoperative atrial arrhythmias, the patients with
postoperative atrial arrhythmia were defined as the new-onset atrial arrhythmi group, the others were considered as the non-atrial
arrhythmia group. The changes of cardiac ultrasound results, ratio of ventricular pacing, pacing site and pacing mode were compared
between the two groups before and after surgery, and logistic regression analysis was used to analyze the factors affecting postoperative
atrial arrhythmia pacemaker through.Results:After 3.9 years' follow-up, there were 26 patients (24.3 % ) with at least one atrial
arrhythmia, including 17 cases with atrial fibrillation (15.9 %); 2 cases with atrial flutter (1.9 %); 7 cases with atrial tachycardia (6.5 %);
81 patients with none atrial arrhythmia. In the new-onset atrial arrhythmi group, there were significantly changes in the left atrial diameter
increased significantly(P=0.040), severe mitral regurgitation(P=0.032) and left ventricular ejection fraction decreased significantly (P=0.
001), ventricular pacing percentage (VP%) was significantly higher (P=0.017), Apical pacing incidence of atrial arrhythmias in patients
was significantly higher than the interval pacing (33.3% vs 1 6.9% , P<0.05), the incidence of atrial arrhythmias in patients with
dual-chamber pacing group was significantly lower than that of the single-chamber pacing control group (18.7% vs 37.5%, P<0.05). But
in the non-atrial arrhythmia patients, there was no changes. Logistic regression analysis showed that the high percentage of ventricular
pacing(VP%)(P=0.006), right ventricular apical(RVA)pacing (P=0.024) and VVI(VVIR) mode (P=0.01 4) before the occurrence of atrial
arrhythmia were the independent predictors of new-onset atrial arrhythmia after pacemaker implantation.Conclusion:Pacing mode, the
percentage of ventricular pacing, pacing sites were the independent predictors of new-onset atrial arrhythmia after pacemaker
implantation. |
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