双腔起搏器治疗严重缓慢性心律失常.doc

双腔起搏器治疗严重缓慢性心律失常        [摘要]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:52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:52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。[关键词] 双腔起搏器心律失常Treatmentwithdual-chamberpacemakerinseverearrhythmiaWuJianhuai,ShanJiang,XiuZiqing(TheSecondAffiliatedHospitalofZhejiangUniversity,Hangzhou,310009) [Abstract]Objective:Toevaluatetheeffectofdual-chamberpacemakerinthe treatmentof52 cases severearrhythmia among them,41 cases with DDD and 11 cases with :There were39casesofsicksinussyndrome(SSS)and13casesofA-Vconductiondiseaseswhichinclude3casesofthirddegreeAVblock(Ⅲ°AVB),1caseofhighdegreeAVblock(HDAVB),5casesoftypeⅡseconddegreeAVblock(typeⅡⅡ°AVB),2casesofthreefascicularblock(TFB),and pleteleftbundlebranchblock(CLBBB).All of them precented a history of a maurosis,syncope and :Aftertheprocedure,52caseswerefollowed-upwitha