Clinical Study Of Low Atrial Septal Pacing And Right Atrial Appendage Pacing

Objective:1.To investigate the effect of low room septal pacing and right atrial appendage pacing on atrial arrhythmias and P wave duration.2.To investigate the difference between low atrial septal pacing and right atrial appendage pacing in the time of implanting operation and pacing parameters.Materials and Methods :1.50 patients with Sinus node dysfunction or adult acquired atrioventricular conduction disturbance resulted in slow arrhythmia with pacing therapy were randomly divided into two groups.Atrial septal group of 25 patients with active fixation electrode for low atrial septal pacing;right atrial appendage group of 25 cases by passive fixation of electrode in right atrial appendage pacing.Compare the electrode implantation operation time of two groups and the pacing parameters of the time of the operation,1 month and 3 months after the operation(threshold and impedance).2.A total of 50 cases of sinus tachycardia with pacemaker implantation were randomly divided into two groups.Atrial septal group of 25 patients with active fixation electrode for low atrial septal pacing;right atrial appendage group 25 cases by passive fixation of electrode in right atrial appendage pacing.Comparison the echocardiographic parameters including left atrial diameter(LAD),left ventricular end diastolic diameter(LVEDD),and left ventricular ejection fraction(LVEF)and new onset atrial arrhythmia and the changes of P wave duration of the two groups after operation in 3 and 12 months.Results:1.With the prolongation of atrial pacing time,cardiac ultrasound examination showed that left atrial diameter(LAD)in low atrial septal pacing group was shortened than right atrial pacing group after 3 months and 12 months of operation,the difference was statistically significant(P<0.05).2.Comparing the two groups in trial lead implantation operation time and pacing parameters at the time of implantation,1 month and 3 months after the operation,it is showed no significant differences(P>0.05).3.With the duration of implantation,right atrial appendage group compared with the real interval group of new onset atrial arrhythmia increased in the number of cases,the difference has statistical significance(P<0.05).P wave duration were less in atrial septal group than in the right atrial appendage group,the difference was statistically significant(P<0.05).Conclusion:1.Left atrial remodeling can be significantly reduced by low atrial septal pacing compared with right atrial pacing.2.Low atrial septal pacing,the right atrial appendage pacing can reduce the incidence of atrial arrhythmia.3.It has the same operation time and the same pacing parameters in electrodes of low atrial septal pacing and right atrial appendage pacing.It can be another effective part of clinical pacing therapy.