双腔起搏器植入术后右心室起搏比例对新发房颤的影响

发布时间：2018-05-10 22:16

  本文选题：双腔起搏器 + 右室起搏比例　； 参考：《广西医科大学》2017年硕士论文

【摘要】：目的:回顾性分析双腔起搏器植入术后右心室起搏比例(心室累积起搏百分比Cum%VP)与新发房颤的关系,分析影响房颤发生的危险因素。方法:对2010年至2014年因II°以上房室传导阻滞(AVB)或病态窦房结综合征(SSS)在我院行双腔起搏器植入术而术前无房颤的患者的随访资料进行回顾性分析。入选病例共109例,其中AVB患者40例,SSS患者69例。患者起搏器随访时间为术后3、6、12个月及以后的每年,随访内容包括右心房起搏比例(Cum%AP)、右心室起搏比例(Cum%VP)、新发房颤情况、心血管事件死亡及卒中情况。按右室起搏比例分为Cum%VP50%、Cum%VP≥50%两组,两组病例数分别为46例、63例。分析两组病人临床基本特征,使用Kaplan-meier法绘制两组病人房颤发生的时间曲线,使用COX比例风险模型进行多因素相关性分析。结果:随时间延长,双腔起搏器植入患者术后新发房颤发生率逐渐增高。入组的109例患者在平均随访45.81±15.97月内,新发房颤72例(66%),其中高起搏比例组(Cum%VP≥50%)新发房颤52例(82.5%),低起搏比例组(Cum%VP50%)新发房颤20例(43.5%)。Kaplan-meier时间曲线显示右室高起搏比例组(Cum%VP≥50%)新发房颤风险高于右室低起搏比例组(Cum%VP50%)(P=0.01 log-Rank),差异有统计学意义。多因素COX分析显示右室高起搏比例是起搏器植入术后新发房颤的独立危险因素(HR1.010;95%CI:1.004-1.016;P=0.001)。结论:长期右室高起搏比例是起搏器植入术后新发房颤的独立危险因素,术前左房内径、左室舒张末径、左心室射血分数(EF%)、基础疾病等与术后新发房颤无关。
[Abstract]:Objective: to retrospectively analyze the relationship between the ratio of right ventricular pacing (CumVP%) and newly occurring atrial fibrillation after double chamber pacemaker implantation, and to analyze the risk factors affecting the occurrence of atrial fibrillation. Methods: the follow-up data of patients without atrial fibrillation who underwent double chamber pacemaker implantation in our hospital from 2010 to 2014 due to AVB (AVB) or sick sinus node syndrome (SSS) were retrospectively analyzed. A total of 109 patients were enrolled, including 40 patients with AVB and 69 patients with SSS. Patients were followed up for 3 months, 12 months and every year after operation. The follow-up included right atrial pacing ratio, right ventricular pacing ratio, newly occurring atrial fibrillation, cardiovascular events death and stroke. According to the ratio of right ventricular pacing, the patients were divided into two groups: group C, V P 50 and C m VP 鈮，

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