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首页> 外文期刊>Journal of cardiology >Atrial septal pacing to resynchronize atrial contraction and improve atrial transport function.
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Atrial septal pacing to resynchronize atrial contraction and improve atrial transport function.

机译：房间隔起搏可重新同步心房收缩并改善心房转运功能。

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OBJECTIVES: Atrial septal pacing via a trans-septal breakthrough site within the right atrial septum can shorten global atrial activation time, resulting in significant reduction of recurrence of atrial fibrillation events. This study examined whether this pacing method will lead to resynchronization of atrial contraction and its benefit on hemodynamic function can be maintained for 24 months. METHODS: Thirty patients with atrial fibrillation and delayed atrial conduction were enrolled (17 males, 13 females, mean age 73 +/- 7 years). Trans-septal breakthrough site within the right atrial septum was identified through pacing from the dorsal left atrium. Continuous atrial septal pacing at the trans-septal breakthrough site was performed for 24 months. Time difference (TD) between right and left atrial contractions was measured during atrial septal pacing and sinus rhythm by pulse Doppler echocardiography of the trans-tricuspid (P-At) and mitral (P-Am) blood flows (TD = P-Am - P-At). RESULTS: The atrial lead was screwed near the fossa ovalis in 29 of 30 patients. Atrial septal pacing yielded significantly shorter P wave duration (101.9 +/- 10.4 vs 139.6 +/- 14.7 msec, p < 0.001), leading to significant reduction of TD in atrial contraction (-8.8 +/- 10.0 vs 29.8 +/- 13.6 msec, p < 0.001)as compared to sinus rhythm. Both shorter P wave duration and reduced TD during atrial septal pacing remained statistically significant during the follow-up period as compared to sinus rhythm. Both left atrial diameter and A to E ratio of filling waves at mitral valve were significantly decreased at 12 months and remained decreased at 24 months. CONCLUSIONS: Atrial septal pacing at the trans-septal breakthrough site can resynchronize atrial contraction and results in improved hemodynamic effects during 24 months of follow-up.
机译：目的：通过右房间隔内的跨房间隔穿刺部位进行房间隔起搏可以缩短整体房激活时间，从而显着减少房颤事件的复发。这项研究检查了这种起搏方法是否会导致心房收缩的重新同步，并且其对血液动力学功能的益处可以维持24个月。方法：招募了30例房颤并延迟房传导的患者（男17例，女13例，平均年龄73 +/- 7岁）。通过从左心房背侧起搏确定右房间隔内的跨隔穿透位点。在隔隔穿刺部位连续进行房间隔起搏24个月。通过三尖瓣（P-At）和二尖瓣（P-Am）血流的脉冲多普勒超声心动图测量房间隔起搏和窦性心律期间左右心房收缩的时间差（TD）（TD = P-Am-拍）。结果：30例患者中有29例心房导线被拧在卵圆窝附近。房间隔起搏产生的P波持续时间显着缩短（101.9 +/- 10.4 vs 139.6 +/- 14.7毫秒，p <0.001），从而导致TD的心房收缩显着降低（-8.8 +/- 10.0 vs 29.8 +/- 13.6毫秒节律，p <0.001）。与窦性心律相比，在随访期间房间隔起搏中较短的P波持续时间和TD降低均具有统计学意义。在12个月时，左心房直径和二尖瓣充盈波的A / E比均显着下降，而在24个月时仍保持下降。结论：跨隔突破点的房间隔起搏可以使心室收缩重新同步，并在随访的24个月内改善血液动力学效应。

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