Compared Study Of The Effect Of Long-term Right Ventricular Single-chamber And Dual-chamber Pacing In Patients On Long-term Quality Of Life

Objective: To evaluate the function of the Chinese version of SF-36 in assessment of the health-related quality of life in Chinese pacemaker implantation(including automatic dual-chamber ventricular pacing DDD and suppressed demand pacing VVI), and to compare the effect of two pacemaker modes about QOL in patients. To select cardiac pacing therapy which can improve QOL in patients and analyze the possible factors.Methods: 142 patients with serious arrhythmias in patients were selected in this study. The patients were divided into two groups according to two kinds of pacing mode: single-chamber pacemaker group(67cases), dual-chamber pacemaker group(75cases). The average follow-up period was(2.8 ± 1.27) years. The basic information of enrolled patients is integral. Using SF-36 scales to evaluate the two groups of patients before and after pacemaker implantation and count the data of quality of life, and to compare them with the relevant statistical methods. To measure and record left atrial diameter, left ventricular end diastolic diameter, right ventricular diameter, left ventricular ejection fraction and other echocardiographic indicators. To explore the impact on cardiac function of two pacemaker modes and its possible mechanism by used SF-36 scale and echocardiography.Results:1. There was no statistically significant difference in average age 、the proportion of men and women、basic heart disease、cardiac function between DDD and VVI group, which was comparable.2. The conclusion after counting eight dimensions of SF-36 scale was: there was a significantly improvement after the operation of patients in two groups. But in the comparison after operation, there was no statistically significant in physiological function, general health, bodily pain vitality, emotional function.(P=0.791, 0.87,0.878, 0.465, 0.481, 0.941), and only physiological functions, social functions in the two groups has statistically significant(P = 0.002, 0.048)3. Echocardiography showed that there was no statistically significant difference between the two groups before and after operation in terms of the left atrium, left ventricle size, the size of the right ventricular diameter, left ventricularejection fraction, left ventricular diastolic function(P>0.05), but the VVI group tended to decrease in left ventricular ejection fraction compared with DDD group(60± 5.57 vs 58.05 ± 5.24, P=0.175), while the VVI group has a decrease trend compared with preoperative in left ventricular ejection fraction(60 ± 5.91 vs 58.05 ±5.24, P = 0.122), but it was no statistically significant difference(P>0.05), DDD group had no significantly difference about echocardiographic indexes before and after operation(P> 0.05). The left atrial size in VVI group has an increasing trend in post-operative(36.017 ± 4.24 vs 37.455 ± 4.4, P = 0.141), there was no significant difference in left atrial size in DDD Group(36.609 ± 4.358 vs 37.768 ± 4.87, P =0.41).Conclusion:1. Chinese version of SF-36 scale in our country can be applied to the evaluation of QOL in patients with pacemaker, and it has a good internal consistency reliability.2. There was no significant differences in DDD and VVI group before the operation about quality of life, and two pacing modes can significantly relieve symptoms, after the operation, only physiological functions and social functions had statistics difference(P<0.05), no significant differences remaining.3. There was no significant statistical significance in terms of cardiac structure between DDD and VVI pacing mode, but the VVI group tended to decrease in left ventricular ejection fraction and VVI group had an increase in left atrial diameter after operation.