本文選題：雙腔起搏器 + 右室起搏比例�。� 參考：《廣西醫(yī)科大學》2017年碩士論文

【摘要】：目的:回顧性分析雙腔起搏器植入術(shù)后右心室起搏比例(心室累積起搏百分比Cum%VP)與新發(fā)房顫的關(guān)系,分析影響房顫發(fā)生的危險因素。方法:對2010年至2014年因II°以上房室傳導阻滯(AVB)或病態(tài)竇房結(jié)綜合征(SSS)在我院行雙腔起搏器植入術(shù)而術(shù)前無房顫的患者的隨訪資料進行回顧性分析。入選病例共109例,其中AVB患者40例,SSS患者69例。患者起搏器隨訪時間為術(shù)后3、6、12個月及以后的每年,隨訪內(nèi)容包括右心房起搏比例(Cum%AP)、右心室起搏比例(Cum%VP)、新發(fā)房顫情況、心血管事件死亡及卒中情況。按右室起搏比例分為Cum%VP50%、Cum%VP≥50%兩組,兩組病例數(shù)分別為46例、63例。分析兩組病人臨床基本特征,使用Kaplan-meier法繪制兩組病人房顫發(fā)生的時間曲線,使用COX比例風險模型進行多因素相關(guān)性分析。結(jié)果:隨時間延長,雙腔起搏器植入患者術(shù)后新發(fā)房顫發(fā)生率逐漸增高。入組的109例患者在平均隨訪45.81±15.97月內(nèi),新發(fā)房顫72例(66%),其中高起搏比例組(Cum%VP≥50%)新發(fā)房顫52例(82.5%),低起搏比例組(Cum%VP50%)新發(fā)房顫20例(43.5%)。Kaplan-meier時間曲線顯示右室高起搏比例組(Cum%VP≥50%)新發(fā)房顫風險高于右室低起搏比例組(Cum%VP50%)(P=0.01 log-Rank),差異有統(tǒng)計學意義。多因素COX分析顯示右室高起搏比例是起搏器植入術(shù)后新發(fā)房顫的獨立危險因素(HR1.010;95%CI:1.004-1.016;P=0.001)。結(jié)論:長期右室高起搏比例是起搏器植入術(shù)后新發(fā)房顫的獨立危險因素,術(shù)前左房內(nèi)徑、左室舒張末徑、左心室射血分數(shù)(EF%)、基礎(chǔ)疾病等與術(shù)后新發(fā)房顫無關(guān)。
[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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