Effect Of Dual-chamber Pacemaker With Automatic Search Atrioventricular Function In Cardiac Synchronization

Objective::To observer the dual-chamber pacemaker whice have search atrioventricular(Search AV)function to influences on cardiac synchronization and function.Methods:51 patients who haves implanted the dual-chamber pacemaker whice have Search Atrioventricular(Search AV)function,and they all come from Yijishan Hospital.The patients include Sick Sinus Syndrome(SSS),second type ii Atrioventricular block and Intermittent Third-degree Atrioventricular block.Those patients were enrolled and divided into SSS group(32 cases)and e AVB group(19 cases).According to the postoperative 1month,1 year follow-up program to observe pacemaker system and patients clinical comprehensive reaction.Cardiac function was evaluated by in terms of Cardiac synchronization parameters(IVMD,SPWMD,QRS),echocardiography parameters(LAEDD,LVEDD,LVEF),and use the pacemaker programmer calculate the cumulative percentage of ventricular pacing(Cum VP%).At different ventricular pacing percentage,compare the change of the two groups’ cardiac synchronization and cardiac function by above correlation parameters.Results: The change appear on the inner diameter of patient’s heart(LAEDD,LVEDD)between SSS group and e AVB group.1.1 Postoperative 1 month:[LAEDD(40.66±5.55VS41.09±4.21,P>0.05),LVEDD(43.81±3.72VS44.61±5.13,P>0.05)] 1.2 Postoperative 1 yea:r[LAEDD(40.93±3.79VS4 42.14±4.61,P>0.05),LVEDD(44.13±7.08 VS 45.23±4.64,P>0.05)] 1.The change appear on the Cardiac function:(LVEF,BNP)between SSS group and e AVB group.2.1 Postoperative 1 month:[LVEF(0.63±0.03VS0.57±0.10,P>0.05),BNP(90.41±50.39VS133.23±67.22,P<0.01)] 2.2 Postoperative 1 year:[[LVEF(0.64±0.05VS0.50±0.07,P<0.01),BNP(61.43±52.29VS143.78±59.68,P<0.01)] 3.The change appear on the cardiac synchronization(IVMD,SPWMD,QRS)and cum ulative proportion of ventricular pacing between SSS group and e AVB group.3.1 Postoperative 1 month:[[IVMD(25.83±1.08VS35.83±1.03,P<0.01),SPWMD(103.44±4.65VS126.44±4.19,P<0.01),QRS(100.78±4.22VS101.21±3.28,P<0.01),Cum VP%(15.63±2.53VS60.43±4.86,P<0.01)] 3.2 Postoperative 1 year:[IVMD(30.34±1.15VS36.65±1.58,P<0.01),SPWMD(113.96±6.01VS142.96±5.91,P<0.01),QRS(100.26±2.79VS107.64±3.12,P<0.01),Cum VP%(16.48±3.11 VS63.60±3.65,P<0.01)]Conclusion:1.Dual-chamber pacemaker having Search AV function,clinic effect in SSS group better than e AVB group;however,It can not reduce the inner diameter of the patient’s heart in short-term;2.About assessment of two groups patients’ cardiac function in postoperative,BNP have a more sensitive than LVEF at early stages;3.Minimizing the ventricular pacing can significantly defer and maintain the patient’s cardiac non-synchronization development;4.Assement Cardiac mechanical dyssynchrony by QRS wave time have some clinical significance at a high proportion of cases of ventricular pacing.