Changes in left ventricular systolic function in patients after pacing in different sites of right ventricle
10.3969/j.issn.1008-0074.2024.03.09
- VernacularTitle:右心室不同部位起搏患者术后左心室收缩功能的变化
- Author:
Shun-Lin TAN
1
;
Sheng ZHANG
;
Li CHEN
;
Lei HUANG
Author Information
1. 资阳市第一人民医院心血管内科,四川资阳 641300
- Keywords:
Cardiovascular diseases;
Cardiac pacing,artificial;
Left ventricular systolic function
- From:
Chinese Journal of cardiovascular Rehabilitation Medicine
2024;33(3):298-302
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the changes of left ventricular systolic function in patients after pacing in differ-ent sites of right ventricle.Methods:The clinical data of 95 patients requiring right ventricular pacing who were ad-mitted to our hospital from February 2018 to May 2020 were collected.According to pacing site,they were divided into right ventricular apex pacing(RVAP)group(n=47)and right ventricular outflow tract septal pacing(RVSP)group(n=48).The pacing threshold,perception threshold,electrode impedance,left ventricular end-diastolic volume(LVEDV),left ventricular end-systolic volume(LVESV),stroke volume(SV),left ventricular ejection fraction(LVEF)were compared between the two groups.According to incidence of cardiac insufficiency on one year after pacing,patients were divided into cardiac insufficiency group(n=18)and normal cardiac function group(n=77).Influencing factors of cardiac insufficiency in patients requiring right ventricular pacing were analyzed.Results:Compared with one week after pacing,on one year after pacing,perception threshold[(11.51±1.21)mV vs.(12.11±0.81)mV]significantly increased in RVAP group,P=0.004.Compared with RVAP group on one year after pacing,there were significant rise in LVESV[(25.32±7.63)ml vs.(29.77±12.36)ml],LVEDV[(58.30±15.71)ml vs.(68.33±25.31)ml],SV[(31.36±10.73)ml vs.(41.29±16.15)ml],and significant reductions in LVEF[(60.55±8.76)％vs.(54.10±6.44)％]and proportion of cardiac insufficiency(27.66％vs.10.42％)in RVSP group,P＜0.05 or＜0.01.Non-conditional multivariate Logistic regression model analysis indicated that LVEF was inde-pendent protective factor for cardiac insufficiency in patients requiring right ventricular pacing(OR=0.854,P=0.003),while RVAP and age ≥60 years were its independent risk factors(OR=9.041,4.145,P=0.003,0.024).Conclusion:Compared with right ventricular apex pacing,right ventricular outflow tract septal pacing can significantly improve stroke volume,and incidence rate of cardiac insufficiency significantly reduces.
