The effect of right ventricular pacing at different sites on cardiac function and psychological state of patients

doi:10.3969/j.issn.1672-5301.2017.10.011

Abstract：Objective To compare the effects of different pacing sites on cardiac function and psycholo gy,including right ventricular outflow tract septum (RVOT) pacing and right ventricular apex (RVA) pacing.Methods 189 patients with cardiac pacemaker treatment treated in our hospital from March 2014 to March 2016 were selected and randomly divided into two groups:93 cases in RVOT pacing group,96 cases in RVA pacing group.Electrocardiogram parameters were compared between the two groups before operation and after 1 week,in cluding QRS duration,QT interval.Ultrasound parameters were compared between the two groups before operation and after 1 year,including the left ventricular diastolic (LVEDD),left ventricular ejection fraction(LVEF),left atrial diameter(LAD).Hamilton Anxiety Rating Scale(HARS) and Hamilton Depression Rating Scale(HDRS) were used to evaluate psychological assessment of patients during 4 times:before operation,after 1week,after 3 months,after 1 year.Results The QRS duration in RVA group and RVOT group were longer than those before operation [(153.23±15.17)ms vs (116.35±14.27)ms,(133.16±11.34)ms vs (117.42±15.82)ms](P＜0.01),QT interval were also longer [(424.06±30.31)ms vs (396.24±45.06)ms,(413.26±33.75)ms vs (395.16±44.44)ms] (P＜0.01),and the QRS duration and QT interval in RVA group were significantly longer than those in RVOT group (P＜0.01).There were significant differences in LVEDD,LVEF and LAD in RVA group after 1 year [(30.96±4.98)mm vs (31.06±5.17)mm,(48.88±5.78)mm vs (49.03±5.86)mm,(48.97±6.97)％ vs (47.83±7.09) mm] (P＜0.01),but no significant difference in RVOT group(P＞0.05).There was no significant difference between the HARS and the HDRS in the RVA group (P＞0.05),and there was significant difference between the three months and the first year(P＜0.05),and 1 week after surgery,3 months after surgery,1 year.Conclusion Compared with RVA pacing,RVOT pacing may less affect cardiac function and psychology of patients,which is more physiological pacing site in clinical.