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《Chinese Journal of Difficult and Complicated Cases》 2010-07
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The effects of right ventricular outflow tract septa and right ventricular apical pacing on cardiac remodeling, aldosterone and angiotensin Ⅱ

LIU Qing-jun,QIAN Jian-feng,LIU Feng,et al.Department of Cardiology,Kun- shan Hospital of TCM,Jiangsu,Kunshan 215300,China  
Objective To compare the effects of right ventricular outflow tract septal(RVS) pacing and right ventricular apical(RVA) pacing on cardiac remodeling,aldosterone(ALD) and angiotensinⅡ(AngⅡ).Met hods Sixty patients with indication of pacemaker implantation were randomly divided into two groups,RVA group and RVS group.The level of ALD and AngⅡwas detected pre and 6m,12m,24m post therapy,and echocardiography examination was applied to measure and follow up the left ventricular end diastolic diameter(LVEDD),left ventricular end systolic diameter(LVESD) and left ventricular ejection fraction(LVEF).Then the difference of cardiac remodeling and heart function in the two groups were observed and compared.Results All patients in two groups were successfully underwent pacemaker implantation.The level of ALD,AngⅡin RVA group increased significantly than pre operation,and it was obviously higher than those in RVS group(P0.05).There was no significant change of ALD,AngⅡin RVS group(P0.05).In the following time after operation,the LVEDD,LVESD increased, and LVEF decreased after 12 months and 24 months in RVA group,of which the difference has statistical significance(P0.05).There was no significant difference of LVEDD,LVESD in RVS group,yet there was downtrend in LVEF,and difference did not show statistical significance(P0.05).Conclusion Compared with RVA pacing,the RVS pacing was more beneficial to decline activation of nerve endocrine,to prevent cardiac remodeling and improve heart function.
【CateGory Index】: R541.7
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