摘要
目的对１０例肥厚型梗阻性心肌病（ＨＯＣＭ）患者行双腔（ＤＤＤ）起搏器治疗，探讨不同ＡＶ间期的血液动力学效应，并对其长期疗效进行评价。方法经锁骨下静脉植入ＤＤＤ起搏器，并同时植入Ｓｗａｎ－Ｇａｎｚ导管及猪尾导管，测量不同ＡＶ间期的血液动力学指标，二维超声心动图测量超声形态学指标，并于起搏器植入后二年随访上述指标。结果所有患者临床症状及心功能明显改善，急性起搏时不同ＡＶ间期的血液动力学均有改善，而以ＡＶ间期为１００ｍｓ、１２０ｍｓ时最明显，左室流出道内径（ＬＶＯＴＤ）增宽，收缩期二尖瓣前向运动程度（ＳＡＭ）明显改善，而起搏后１年、２年随访与起搏后即刻相比，上述指标均无显著变化。结论ＤＤＤ起搏可做为药物难治性ＨＯＣＭ的一种有效方法。
Objective To observe
the hemodynamic effects of dual chamber pacing (DDD) at various AV intervals,and evaluate its
long term effects in 10 patients with obstructive hypertrophic cardiomyopathy (HOCM) Methods
DDD pacemaker was implanted via subclavian vein.A SwanGanz catheter and a Cordis endhole
catheter were placed to measure the hemodynamic parameters,2dimensional Doppler
echocardiography was performed to measure relevant parameters at various AV intervals of
pacing.The abovementioned parameters were measured after one year and two years of pacing.
Results The clinical symptoms and NYHA functional status of all patients were considerably
improved.Hemodynamic effect was significantly improved in various AV intervals especially
with 100 and 120 ms of AV intervals immediately after pacing,Left ventricular outflow tract
dimension (LVOTD) increased and degree of systolic anterior movement of mitral valve (SAM)
improved significantly.After 1 year and 2 years of DDD pacing,the abovementioned parameters
were not significantly different as compared with that in acute postpacing period. Conclusion
DDD pacing is an effective form of therapy in patients with drugresistant HOCM.
出处
《中华心律失常学杂志》
1999年第1期12-15,共4页
Chinese Journal of Cardiac Arrhythmias
关键词
双腔起搏器
肥厚型
梗阻性
心肌病
血液动力学
Dualchamber pacemakerObstructive hypertrophic
cardiomyopathyHemodynamicsEchocardiography
