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目的:探讨置入了双腔起搏器的患者,在随访时,根据体表心电图P波宽度调节房室传导间期(AV间期)对血流动力学的影响。方法:因高度或Ⅲ度房室传导阻滞而安装美墩力SD303双腔起搏器的患者31例。测量患者体表心电图自身P波宽度,和(或)心房起搏脉冲至起搏的P波末端的宽度,在此测量值上加100ms,分别设定双腔起搏器的感知AV间期和起搏AV间期。使用多普勒超声仪,分别在出厂常规设置的AV间期和根据体表心电图优化的AV间期设定值,进行超声检查。结果:经体表心电图调整AV间期后的左室每搏量、左室舒张末期容量和左室射血分数、左室充盈时间、二尖瓣血流速度时间积分,均高于常规出厂设置的AV间期,前三者差异显著(P<0.05)。结论:根据体表心电图中P波宽度的变化来调节AV间期,不但能获得良好的血流动力学效果,且由于其简单易行,而具有广泛的临床实用价值。
PURPOSE: To investigate the effects of atrioventricular conduction (AV interval) on hemodynamics in patients undergoing dual-chamber pacemaker at follow-up based on the P-wave width of the body surface electrocardiogram. METHODS: Thirty-one patients with USPD SD303 dual-chamber pacemaker due to height or degree atrioventricular block were enrolled. Measure the P-wave width of the body surface ECG and / or the width of the atrial pacing pulse to the end of the P-wave of pacing. Add 100 ms to the measured value to set the perceptual AV interval and Pacing AV interval. Doppler ultrasound system, respectively, at the factory routine settings of the AV interval and based on the body surface ECG optimized AV interval set value for ultrasound examination. Results: Left ventricular stroke volume, left ventricular end-diastolic volume, left ventricular ejection fraction, left ventricular filling time, and mitral flow velocity time integral after adjusting AV interval by body surface electrocardiogram were higher than the conventional factory settings Of the AV interval, the first three significant differences (P <0.05). Conclusion: According to the changes of P wave width in body surface electrocardiogram to adjust the AV interval, not only can obtain good hemodynamic effect, but also has a wide range of clinical practical value due to its simple and easy operation.