The Influence On Plasma Levels Of IL-1β And IL-6 In Patients With Different Pacing Sections Of Right Ventricular Early

Objective:We sought to find the ideal pacing section by comparing the influence to patients' plasma levels of Interleukin-1βand Interleukin-6 in right ventricular apex pacing early with that in right ventricular septum pacing early.Methods:We selected 60 patients with permanent cardiac pacemaker implantation, who implanted type DDD or DDDR pacemaker, and separated them into three groups according to different ventricular lead placement and different pacing ratio of right ventricular:right ventricular apex (RVA) pacing group, right ventricular septum (RVS) pacing group and the matched group. We compared their preoperative electrocardiogram with their own cardiac rhythm, and the time limit and shapes of QRS waves on their pacing electrocardiogram, as well to observe and compare the postoperative changes of plasma levels of Interleukin-1β(IL-1β) and levels of Interleukin-6 (IL-6) between three groups besides in a week and in three mouths.Results:(1)the time limit of QRS waves on their pacing electrocardiogram in right ventricular apex pacing group is greater obviously than that in right ventricular septum pacing group after implant pacemaker, and this difference between them has statistical significance (P<0.05);(2)①neither the preoperative plasma levels of IL-1βnor the preoperative plasma levels of IL-6 between three groups has statistical difference (P>0.05);②fter operation a week, plasma levels of IL-1βin both RVA pacing group and RVS pacing group go up by comparing with their preoperative levels respectively, and it is higher obviously in RVA pacing group than that in RVS pacing group (P<0.05);after operation three mouths, plasma levels of IL-1βin RVA pacing group is higher than preoperative quantity, which is statistically significant (P<0.05); the plasma levels of IL-1βcomparing with preoperative levels in RVS pacing group has no statistical difference (P>0.05), and plasma levels of IL-1βin RVA pacing group is significantly higher than that in RVS pacing group (P<0.05);③fter operation a week, plasma levels of IL-6 are significantly higher than preoperative's both in RVA pacing group and in RVS pacing group, and it is similar when implanting pacemaker three mouths later (P<0.05); plasma levels of IL-6 in RVA pacing group is significantly higher than that in RVS pacing group both after operation a week and three mouths (P<0.05); ④The correlationship between plasma levels of IL-1βand IL-6 of three groups in above-mentioned periods have no significance (P>0.05), but the correlationship between IL-1βand IL-6 of three groups when analysis in the mass is positive correlation (P=0.000).Conclusion:the time limit of QRS waves with right ventricular septum pacing is less obviously than that with right ventricular apex pacing, right ventricular septum pacing is more advantageous in keeping the electro-excitement synchronism between both ventricles, and has more little influence to plasma levels of IL-1βand IL-6, which may reduce the disadvantageous influence to the heart function, so right ventricular septum is a relatively ideal pacing section.