【摘要】 目的 了解心房按需起搏器(AAI)植入术后窦房结和房室传导功能的远期转归。方法 对22例植入AAI起搏器患者用食管心房起搏检测术后远期双结功能电生理参数，并与术前比较分析(t检验)。随访时间30～102个月。结果 窦房结功能：SACT、SNRT、CSNRT参数与术前比较(P>0.25)差异无显著性。房室传导功能：心电图未发现显性房室传导障碍，术前房室传导功能障碍者未见明显加重，检测房室传导文氏阻滞点无隐性阻滞，与术前比较(P>0.25)，差异无显著性。房室传导2∶1阻滞点，与术前比较(P>0.25)差异无显著性。结论 病态窦房结综合征患者植入AAI起搏器后，窦房结功能和房室传导功能未见有意义的减退，也未出现起搏器依赖性。

HUANG Chengyi.People's Hospital of Fenghua,Fenghua 315500

【Abstract】 Objective To assess the long-term consequence of sino-atrial nodal(SAN)and atrio-ventricular nodal(AVN)functions after permanent AAI pacing. Method Parameters reflecting SAN and AVN functions measured with trans-esophageal atrial pacing technique prior to and 30～120 months after implantation of AAI pacemaker in 22 patients were assessed and compared. Results About the SAN function,the sino-atrial conduction time(SACT),sinus node recovery time(SNRT)and corrected sinus node recovery time(CSNRT)were longer than that of pre-operative values in 17 cases(77.27%),but became shortened in 5 case(22.71%),and even returned to normal in one of them.On the whole scale,the differnce was not significant(P>0.25).About the AVN function,no manifestating AVN conduction disorder could be observed in conventional ECG during follow-up.Occult minor AVN conduction dysfunction in some patients before implantation was not worsened during follow-up.The Wenckebach points were lowered(but still above 120 bpm)in 13 cases(59.09%),but were improved in 6 cases(13.64%).The AVN 2∶1 block points were lowered in 11 cases (50%),but were improved in 5 cases(22.27%),and had no chang in 6 cases(22.27%).On the whole scale,the difference was insignificant(P>0.25). Conclusion SAN and AVN functions would not be deteriorated further after AAI pacemaker implantation.No pacemaker dependence occurred in this series.

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