Changes Of QRS Duration And Blood Atrial Natriuretic Peptide In Patients With Right Ventricular Septa Pacing

Objective To investigate the advantage of right ventricular septum pacing (RVS) by observing the changes of QRS duration and atrial natriurietic peptide (ANP) in different pacing positions of the right ventricular:right ventricular apex pacing (RVA) group and right ventricular septum pacing(RVS) group.Method 40 patients with cardiac pacing, in line of pacemaker implanted indicationⅠorⅡa, were divided into RVA pacing group (n=20) and RVS pacing group(n=20) according to different pacing positions. Their pacing ECGs were taken 1 week postoperatively. Complete pacing QRS durations were measured, and then compared the average parameters accordingly.60 patients with cardiac pacing, in line of pacemaker implanted indicationⅠorⅡa. were divided into 3 groups according to patients pacing heart beats account for proportion of total heart beats and different pacing positions:control pacing group, (n=20,8 male and 12 female, average age 68.1±7.11), RVA pacing group (n=20,15 male and 5 female, average age 68.7±10.58) and RVS pacing group (n=20,14 male and 6 female, average age 63.6±6.93). ANP in venous blood of patients were assayed by ELISA before operation and 1 week,3 months postoperatively. ANP levels changed in different periods and pacing positions were compared.Result QRS durations:compared to patients' pacing ECG between the 2 groups, average QRS durations in RVS pacing group was 112.25±15.02ms, average QRS durations in RVA pacing group was 146.95±20.27 ms. Average QRS duration in RVS pacing was shorter than that in RVA group, the difference was statistically significant(P<0.01).ANP level:before the operation, average ANP in RVS pacing group was 132.3465±24.5428pg/ml, RVA pacing group was 132.218±25.1935pg/ml, control pacing group was 126.195±32.8228pg/ml.1 week postoperatively, average ANP in RVS pacing group was 135.5865±21.1033pg/ml, RVA pacing group was 134.623±27.5723pg/ml, control pacing group was 137.216±18.689pg/ml.3 months postoperatively, average ANP in RVS pacing group was 144.97±29.07pg/ml, RVA pacing group was 220.89±40.96pg/ml, control pacing group was 132.68±23.13 pg/ml. Average ANP in RVS pacing group was lower than that in RVA pacing group, the difference was statistically significant(P<0.01). Compared to average ANP between control pacing group and the RVS group, the difference was not statistically significant(P> 0.05).Conclusion①RVS pacing can get close to physiological state of the ventricular activation sequence, the average QRS duration was shorter than that in RVA group;②average ANP in RVS pacing group was lower than that in RVA pacing group. RVS pacing was better than RVA pacing.