左束支区域起搏对房室传导阻滞患者术后新发房性心律失常的影响

doi:10.3969/j.issn.1006-5725.2024.13.014

Abstract

Abstract:

Objective To investigate the effect of left bundle branch area pacing （LBBaP） on new-onset atrial fibrillation （NOAF） and atrial high rate episodes （AHREs） in patients with atrioventricular block （AVB）. Methods Eighty-four patients with Ⅲ^°AVB for pacemaker implantaion were divided into the LBBaP group （n = 42） and the RVSP group （n = 42） based on the site of the ventricular leads. The two groupswere compared in terms of the pre- and post- operative QRSd， ventricular pacing parameters， complications， incidence of stroke， NOAF and AHREs. Results （1） The incidence of postoperative NOAF and AHREs in the LBBaP group was significantly lower compared with RVSP group （P < 0.05）. （2） The p-QRSd in the LBBaP group was significantly shorter compared with RVSP group （P < 0.05）. （3） The two groups showed no significant differences in ventricular pacing parameters， incidence of complications and stroke events （P > 0.05）. Conclusion LBBaP is superior to right ventricular pacing in reducing the incidence of postoperative AHREs and NOAF in patients after implantation and improving the prognosis of patients.

Key words: left bundle branch area pacing, right ventricular pacing, atrial fibrillation, atrial high rate episodes, atrioventricular block

CLC Number:

R541.75

Yongxu ZHANG,Yuesong WANG,Da YANG,Xuebin DONG,Mingyong CAO,Shaojun WANG,Kexiang. TU. Effect of left bundle branch area pacing on new⁃onset atrial arrhythmia after implantation[J]. The Journal of Practical Medicine, 2024, 40(13): 1846-1850.

Figures/Tables 5

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References 25

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项目	LBBaP组（n = 42）	RVSP组（n = 42）	t/χ²值	P值
男性［例（%）］	28（66.70）	25（59.50）	0.460	0.498
年龄（岁）	74.64 ± 7.30	72.02 ± 9.08	1.457	0.149
吸烟史［例（%）］	10（23.8）	14（33.3）	0.933	0.334
高血压病［例（%）］	31（73.8）	36（85.7）	1.844	0.175
糖尿病［例（%）］	7（16.7）	12（28.6）	1.700	0.192
冠心病［例（%）］	7（16.7）	5（11.9）	0.389	0.533
LAD（mm）	33.48 ± 4.71	32.57 ± 4.96	0.857	0.394
LVEDD（mm）	50.26 ± 3.31	50.86 ± 4.08	0.734	0.465
LVEF（%）	49.10 ± 3.84	49.83 ± 3.25	0.950	0.345
Cum AP（%）
术后12个月	7.25 ± 2.45	8.06 ± 2.90	0.227	0.821
术后24个月	7.37 ± 2.54	8.56 ± 2.82	0.786	0.434

组别	起搏阈值（V）			心室感知（mV）			电极阻抗（Ω）
组别	术中	术后12个月	术后24个月	术中	术后12个月	术后24个月	术中	术后12个月	术后24个月
LBBaP组	0.82 ± 0.15	0.66 ± 0.19	0.65 ± 0.20	11.20 ± 1.10	11.42 ± 0.91	11.45 ± 0.92	727 ± 70	690 ± 73	687 ± 59
RVSP组	0.80 ± 0.18	0.65 ± 0.21	0.67 ± 0.19	11.10 ± 0.80	11.09 ± 1.07	11.17 ± 0.98	737 ± 71	684 ± 78	673 ± 69
t值	0.78	0.16	0.62	0.47	1.56	1.34	0.61	0.37	1.03
P值	0.44	0.87	0.54	0.64	0.12	0.18	0.55	0.71	0.30

组别	术前	术后12个月	术后24个月
LBBaP组	110.3 ± 25.4	123.4 ± 6.0	123.6 ± 6.6
RVSP组	109.9 ± 23.2	137.2 ± 7.0	137.2 ± 4.9
t值	0.081	9.682	11.06
P值	0.936	< 0.01	< 0.01

项目	超声心动图参数			NT-proBNP（pg/mL）
项目	LAD（mm）	LVEDD（mm）	LVEF（%）	NT-proBNP（pg/mL）
LBBaP组
术前	33.48 ± 4.71	50.26 ± 3.31	49.10 ± 3.84	425.48 ± 129.35
术后12个月	33.61 ± 4.94	50.31 ± 3.27	54.88 ± 4.28^*	357.37 ± 114.05^*
术后24个月	33.64 ± 4.99	50.33 ± 3.24	53.81 ± 4.76^*	365.65 ± 116.43^*
RVSP组
术前	32.57 ± 4.96	50.86 ± 4.08	49.83 ± 3.25	423.32 ± 127.76
术后12个月	32.64 ± 4.91	50.93 ± 4.01	48.76 ± 3.28	446.23 ± 132.20
术后24个月	40.86 ± 5.03^*	51.50 ± 4.06^*	44.93 ± 2.97^*	472.08 ± 138.84^*

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Effect of left bundle branch area pacing on new⁃onset atrial arrhythmia after implantation

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