<
正>双腔起搏器可以感知和起搏右心房和右心室
优化起搏参数的重要原则之一是减少右心室起搏比例。循证医学研究证实:右心室起搏
尤其是右心室心尖起搏
可加重心力衰竭(心衰)
[1-4]
。一.右心室起搏加重心衰的机制右心室起搏可导致右心室先于左心室收缩
即左右心室间收缩不同步。右心室起搏与左束支阻滞有相似效应
可导致室间隔先于外侧壁收缩
即左心室内收缩不同步。心室收缩同步性丧失必然降低心脏泵血功能的整体效率。这种心脏泵血功能改变在无心肌病时可能无临床意义
但其对心衰患者影响较大
可导致心衰症状加重
[5]
。
<
正>双腔起搏器可以感知和起搏右心房和右心室
优化起搏参数的重要原则之一是减少右心室起搏比例。循证医学研究证实:右心室起搏
尤其是右心室心尖起搏
可加重心力衰竭(心衰)
[1-4]
。一.右心室起搏加重心衰的机制右心室起搏可导致右心室先于左心室收缩
即左右心室间收缩不同步。右心室起搏与左束支阻滞有相似效应
可导致室间隔先于外侧壁收缩
即左心室内收缩不同步。心室收缩同步性丧失必然降低心脏泵血功能的整体效率。这种心脏泵血功能改变在无心肌病时可能无临床意义
但其对心衰患者影响较大
可导致心衰症状加重
[5]
。
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AV block and changes in pacing mode during long-term follow-up of 399 consecutive patients with sick sinus syndrome treated with an AAI/AAIR pacemaker. [J] . Kristensen L,Nielsen J C,Pedersen A K,Mortensen P T,Andersen H R. Pacing and clinical electrophysiology : PACE . 2001 (3)
Atrioventricular conduction during long-term follow-up of patients with sick sinus syndrome. [J] . Andersen H R,Nielsen J C,Thomsen P E,Thuesen L,Vesterlund T,Pedersen A K,Mortensen P T. Circulation . 1998 (13)
Increased risk of progressive hemodynamic deterioration in advanced heart failure patients requiring permanent pacemakers [J] . Saxon Leslie A,Stevenson William G,Middlekauff Holly R,Stevenson Lynne W. American Heart Journal . 1993 (5)
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