论文部分内容阅读
目的比较心脏再同步治疗(CRT)VV间期的超声心动图优化方法与心电图优化方法的相关性。方法入选36例CRT植入术后大于3个月的病例,选择左室领先30ms、双室同步、右室领先30ms、60ms5种VV间期,用超声心动图VTI替代每搏输出量,并设立相应VV间期为最佳VV间期。两种心电图优化方法同时进行。第1种为QRS波时限法:描记出最窄QRS波为最佳VV间期。第2种为心室间激动延迟法:即分别在胸前导联(最好V1或V2导联)记录从起搏信号到QRS波形态最早出现变化的间期,仅左室起搏时所获得的间期记为T1,仅右室起搏时获得的间期记为T2。T2-T1代表最佳VV间期。结果超声优化的最佳VV间期左室领先为负值,左室与在后第1种心电图优化方法与VTI符合率64%(r=0.61,p<0.01);第2种心电图优化方法符合率为86%(r=0.82,p<0.001);联合上述两种心电图方法,其符合率达92%(r=0.90,p<0.0001)结论 CRT的VV间期优化中,与超声心动图优化对比,联合两种心电图方法其相关性最高。
Objective To compare the echocardiographic optimization of cardiac resynchronization therapy (CRT) with that of electrocardiogram (ECG) optimization. Methods Thirty-six patients who underwent CRT implantation for more than 3 months were enrolled in the study. Left ventricular lead 30ms, double-chamber synchronization, right ventricular lead 30ms, 60ms VV interval were selected. Echocardiographic VTI was used to replace the stroke volume and established The corresponding VV interval is the best VV interval. Both ECG optimization methods are performed simultaneously. The first one is QRS wave duration method: trace the narrowest QRS wave for the best VV interval. The second is the inter-ventricular activation delay method: that is, in the lead of the thoracic cavity (best V1 or V2 lead), the earliest change of pacing waveform and QRS wave pattern is recorded, and only the left ventricular pacing is obtained Of the interval recorded as T1, pacing obtained only when the right ventricle recorded as T2. T2-T1 represents the best VV interval. Results The best optimal VV interval left ventricular lead was negative, the coincidence rate of the left ventricle and the latter first electrocardiogram was 64% (r = 0.61, p <0.01) with VTI, and the second electrocardiogram was consistent with (R = 0.82, p <0.001). The coincidence rate of these two electrocardiographic methods was 92% (r = 0.90, p <0.0001). Conclusion The VV interval optimization of CRT was better than that of echocardiography In contrast, combining the two ECG methods has the highest correlation.