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目的探究起搏器术后房性心律失常的发生率及其相关影响因素,为缓慢性心律失常非药物治疗提供依据。方法选取医院心内科首次植入永久起搏器的120例患者为研究对象,根据患者术后是否发生房性心律失常将其分为新发房性心律失常组(A组,20例)和无房性心律失常组(B组,100例),比较2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、起搏模式、房性心律失常的发生率,并通过logistic回归分析对其术后发生房性心律失常的影响因素进行分析。结果对120例患者进行为期4年的随访,发生起搏器术后房性心律失常的患者为20例,占16.67%;A组LA增加值更为明显(P<0.05),A组LA为(4.2±2.5)mm,B组LA为(2.2±1.5)mm;A组LVEF为(0.02±0.03),B组LVEF为(0.07±0.05),A组与B组比较LVEDD变化无明显差异(P>0.05)。A组心室起搏百分比(VP%)较B组明显增高(P<0.05),A组VP%为(85.3±15.1)%,B组VP%为(35.3±11.1)%。经logistic回归分析,心室起搏比例、心尖部位起搏、VVI起搏模式均为起搏器术后房性心律失常发生的危险因素。结论起搏器术后有一定数量的患者会出现房性心律失常,引起起搏器术后发生房性心律失常的影响因素主要为起搏模式、心室起搏百分比和起搏部位。
Objective To investigate the incidence of atrial arrhythmia after pacemaker operation and its related factors, to provide a basis for non-drug treatment of bradyarrhythmia. Methods A total of 120 patients with permanent pacemaker implanted in Department of Cardiology of the Hospital for the first time were enrolled in this study. Patients were divided into new arrhythmia group (group A, n = 20) and non-arrhythmia group Atrial arrhythmia group (group B, n = 100). The changes of preoperative and postoperative cardiac ultrasonography, ventricular pacing rate, pacemaker location, pacemaker mode and atrial arrhythmia were compared between two groups Logistic regression analysis of the impact of its occurrence of atrial arrhythmia factors. Results A total of 120 patients were followed up for 4 years. Atrial arrhythmia occurred after pacemaker operation in 20 patients (16.67%). LA in group A was more obvious (P <0.05) (4.2 ± 2.5) mm in group B and (2.2 ± 1.5) mm in group B. The LVEF in group A was (0.02 ± 0.03) and that in group B was (0.07 ± 0.05). There was no significant difference in LVEDD between group A and group B P> 0.05). The percentage of ventricular pacing in group A was significantly higher than that in group B (P <0.05). The VP% in group A was (85.3 ± 15.1)% and that in group B was (35.3 ± 11.1)%. Logistic regression analysis, ventricular pacing ratio, apical pacing, VVI pacing mode are risk factors for atrial arrhythmia after pacemaker operation. Conclusion Atrial arrhythmia occurs in a certain number of patients after pacemaker operation. The main influencing factors of atrial arrhythmia after pacemaker operation are pacing mode, percentage of ventricular pacing and pacemaker site.