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目的探讨心室超速起搏对动脉压力的影响,以明确其在主动脉腔内隔离术中的应用价值。方法对30例左侧旁路射频消融术后患者,以180～220次/min的频率行心室超速起搏,使外周平均动脉压下降至60 mmHg(1 mmHg=0.133 kPa),通过有创动脉压力持续同步监测血压并记录压力图形的变化,观察心室超速起搏前后血压下降的速度和幅度及血压降至目标血压所需时间,停止起搏后血压恢复至基础血压的速度和幅度及所需时间;观察患者在超速起搏术中及术后3个月有无心、脑、肾等器官的不良事件。结果入选的30例患者顺利完成心室程序刺激。心室超速起搏(3.1±1.6)心搏后外周动脉平均动脉压从91.3 mmHg下降至37.8 mmHg,目标平均动脉压达标需(858.7±361.7)ms。停止起搏后(1.9±0.6)心搏后平均动脉压恢复至基础水平,约需(1 042.2±174.0)ms。术中、术后3个月随访患者无心、脑、肾等脏器的不良事件。结论心室超速起搏可以迅速、安全、有效地控制平均动脉压,可作为主动脉覆膜支架释放时较佳的血压控制手段。
Objective To investigate the effect of ventricular pacing on arterial pressure in order to clarify its value in aortic endoluminal isolation. Methods Thirty patients with left bypass radiofrequency ablation were performed ventricular pacing at a frequency of 180 to 220 beats / min to decrease the mean peripheral arterial pressure to 60 mmHg (1 mmHg = 0.133 kPa) Pressure continuously monitor blood pressure and record changes in pressure pattern, observed ventricular pacing speed before and after descending blood pressure and amplitude and blood pressure to target blood pressure required time to stop pacing blood pressure recovery to the speed and magnitude of the base and the required Time; observation of patients in the speeding pacing and 3 months after surgery without heart, brain, kidney and other organ adverse events. Results 30 patients selected successfully completed ventricular program stimulation. After ventricular pacing (3.1 ± 1.6), the mean arterial pressure of peripheral artery decreased from 91.3 mmHg to 37.8 mmHg, and the mean target arterial pressure reached 858.7 ± 361.7 ms. After stopping pacing (1.9 ± 0.6), mean arterial pressure recovered to basal level after heartbeat, which was about (1 042.2 ± 174.0) ms. Intraoperative and postoperative 3-month follow-up of patients without heart, brain, kidney and other organ adverse events. Conclusion Ventricular tachycardia can control mean arterial pressure rapidly, safely and effectively, which can be used as a better blood pressure control method when aortic stent graft is released.