摘要
通过采用 5种不同的心脏起搏方式 ,观察房室同步和心室激动顺序对犬急性血液动力学和心肌力学的影响。方法 :选用健康犬 10只 ,随机顺序进行右心房起搏 (RAP)、右房 His束顺序起搏 (AHSP)、右房 右室顺序起搏(AVSP)、His束近端起搏 (HBP)和右心室起搏 (RVP) ,在每种起搏稳定 5min后测定有关血液动力学和心肌力学参数。结果 :RAP和AHSP对血液动力学和心肌力学无显著影响 ;AVSP时心输出量 (CO)、等容收缩期左室压力最大上升速率 (+dp/dtmax)和等容舒张期左室压力最大下降速率 (-dp/dtmax)分别降低了 16 .32 % ,15 .0 1% ,15 .19% ;HBP时平均肺动脉压 (mPAP)、肺毛细血管楔压 (PCWP)、左室舒张末压 (LVEDP)均升高 ,而CO降低了 14.93 % ;RVP时mPAP、PCWP、LVEDP均明显升高 ,CO、+dp/dtmax和 -dp/dtmax分别降低了 2 3.95 % ,2 2 .2 8% ,19.74%。结论 :丧失房室同步活动引起左室前负荷变化 ,影响整体收缩功能 ;而心室激动顺序异常既影响左室收缩功能 。
We observed the acute changes of hemodynamics and cardiac mechanics during five kinds of pacing mode in order to assess the effect of atrio ventricular synchrony and ventricular activation sequence.Five kinds of pacing mode including RAP,AHSP,AVSP,HBP and RVP were performed in ten dogs at random,and hemodynamic parameters and cardiac mechanical parameters were measured after stable pacing was achieved for 5 minutes.Results:RAP and AHSP showed no significant change on hemodynamics.During AVSP,CO,+dp/dt max ,and -dp/dt max decreased 16.32%,15.01%,and 15.19% respectively.During HBP,there showed an increment of mPAP,PCWP and LVEDP,and CO decreased 14.93%.During RVP,there showed an increment of mPAP,PCWP and LVEDP,and CO,+dp/dt max ,and -dp/dt max decreased 23.95%,22.28%,and 19.74% respectively.Conclusion:Loss of AV synchrony affect global systolic function by the change of LV preload,and abnormal ventricular activation sequence decreases both of the left ventricular systolic and diastolic function.It is important for us to preserve AV synchrony and normal ventricular activation sequence in cardiac pacing.
出处
《中国心脏起搏与心电生理杂志》
2001年第1期47-49,共3页
Chinese Journal of Cardiac Pacing and Electrophysiology
