ÖZET
Amaç:
Atriyoventriküler (AV) tam bloklu hastalarda kalıcı pacemaker mod seçiminin uzun dönem klinik sonuçları incelendi.
Yöntem:
AV tam blok nedeni ile kalıcı pacemaker takılan toplam 161 hasta retrospektif olarak incelendi. Fizyolojik pacemaker (FP) grubu altında incelenen hastaların 95’inde VDD, 14’ünde DDD modu bulunmaktaydı. Ventriküler pacemaker (VP) grubu içinde incelenen 52 hastada VVI modu mevcuttu.
Bulgular:
Ortalama yaş 66±13 yıl ve ortalama takip süresi 40,2±22,6 ay idi. Takip süresinde, VP grubunda, FP grubu ile karşılaştırıldığında daha fazla oranda atriyal fibrilasyon (AF) saptandı (p=0,007). İnme gelişimi açısından iki grup arasında bir fark bulunmadı (p=0,753). Pacemaker takılmadan önce konjestif kalp yetersizliği (KKY) bulunmayan hastalar incelendiğinde, takip süresi esnasında VP grubunda daha fazla oranda KKY gelişimi tespit edildi (p=0,015). Başlangıçta KKY bulunan ve bulunmayan hastalar birlikte incelendiğinde, takip süresi sonunda FP’li grupta KKY bulunan hastaların sayısı azalırken (p=0,039), VP’li grupta istatistiksel olarak anlamlı olmayan düzeyde bir artma saptandı (p=0,219).
Sonuç:
AV tam bloklu hastalarda FP kullanımı, VP kullanımı ile karşılaştırıldığında, uzun dönemde AF ve KKY gelişimini azaltabilir.
References
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