论文部分内容阅读
目的 :评价双腔起搏器治疗严重缓慢性心律失常的临床疗效及价值。方法 :5 2例双腔起搏器 ,其中 41例DDD起搏器 ,11例DDDR起搏器。病态窦房结综合征 (sicksinussyndrome,SSS) 39例 ,房室传导障碍 13例 ,其中包括Ⅲ度房室传导阻滞 (thirddegreeAVblock ,Ⅲ°AVB) 3例 ,高度房室传导阻滞 (highdegreeAVblock ,HDAVB) ,Ⅱ度Ⅱ型房室传导阻滞 (typeⅡseconddegreeAVblock ,Ⅱ°Ⅱ型AVB) ,三分支传导阻滞 (threefascicularblock ,TFB)病人 ,以上病人均伴有昏厥、黑朦或严重头晕。电极植入途径为锁骨下静脉或头静脉。结果 :5 2例术后随访 1 78个月 ,临床疗效显著 ,不仅防止心博骤停发生 ,脑缺血症状消失 ,而且生活质量明显提高。 3例SSS者阵发房颤 (atrialfibrillation ,Af)术后消失 ,10例SSS者结合药物治疗Af发作次数减少。 1例扩张性心肌病死于左心衰竭。并发症 :心房感知过度 2例 ,心房感知不足 1例 ,心室电极阈值升高 1例 ,囊袋感染 1例 ,血肿 1例。结论 :双腔起搏器为较理想的生理性起搏 ,本研究证实能有效地治疗严重SSS和房室传导障碍的病人
Objective: To evaluate the clinical efficacy and value of dual chamber pacemaker in the treatment of severe chronic arrhythmia. Methods: 52 cases of double chamber pacemaker, including 41 DDD pacemaker, 11 DDDR pacemaker. 39 cases of sick sinus syndrome (SSS), 13 cases of atrioventricular conduction disorders, including 3 degree atrioventricular block (Ⅲ ° AVB) in 3 cases, a high degree of atrioventricular block (HDAVB ), Type Ⅱ second degree atrioventricular block (Ⅱ Ⅱ Ⅱ AVB), threefascicular block (TFB) patients, these patients are associated with syncope, darkness or severe dizziness. Electrode implantation is the subclavian vein or cephalic vein. Results: Fifty-two cases were followed up for 78 months. The clinical effect was significant. It not only prevented the arrest of cardiac arrest but also disappeared the symptoms of cerebral ischemia, and the quality of life improved significantly. Atrial fibrillation (Af) disappeared in 3 cases of SSS, and the number of Af episodes in 10 cases of SSS decreased with drug treatment. One case of dilated cardiomyopathy died of left heart failure. Complications: 2 cases of atrial hypersensitivity, 1 case of atrial insufficiency, 1 case of ventricular electrode threshold increase, 1 case of bladder infection and 1 case of hematoma. CONCLUSIONS: Dual chamber pacemakers are more ideal for physiological pacing and this study demonstrates that patients with severe SSS and atrioventricular conduction can be effectively treated