Meta Analysis of Dual-chamber Pacing and Ventricular Single-chamber Pacing for the Treatment of Cardiac Arrhythmia_West China Medical Journal

Authors：

 MinMin ,  XiongShixi

Department of Cardiovascular Medicine, Zhongnan Hospital of Wuhan University, Wuhan, Sichuan 430071, P. R. China;

Corresponding author：

XiongShixi, Email: doctorxiong@qq.com

Keywords：

Dual-chamber pacing; Ventricular single-chamber pacing; Cardiac arrhythmia; Randomized controlled trials; Mata-analysis

DOI：

10.7507/1002-0179.201600367

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To compare the therapeutic effect of dual-chamber pacing (DDD) and ventricular single-chamber pacing (VVI) on arrhythmia via systematic evaluation. Methods With the method of Cochrane system evaluation, we searched Medline, Embase, CNKI, PubMed and Wanfang database (the searching time was up to June 30, 2016) for randomized controlled trials comparing DDD with VVI treatingcardiac arrhythmias. Meta analysis was performed using RevMan5.3 software. Results We collected 12 randomized controlled trials of DDD and VVI pacing treating cardiac arrhythmia including 1 704 patients, but the quality of the studies were not good. The results of Meta analysis showed that:compared with VVI pacing mode, DDD pacing mode reduced the risk of atrial fibrillation[RR=0.36, 95%CI (0.22, 0.59), P < 0.000 1]; besides, it reduced the left atrial diameter[SMD=-0.43, 95%CI (-0.68, -0.17), P=0.001], the left ventricular end diastolic dimension[SMD=-0.33, 95%CI (-0.61, -0.05), P=0.02] and increased the left ventricular ejection fraction[SMD=1.03, 95%CI (0.49, 1.57), P=0.000 2]. Conclusions Comparing DDD with VVI on the treatment of cardiac arrhythmia in patients with cardiac arrhythmia, DDD pacing can reduce the incidence of atrial fibrillation and thrombosis, enhance heart function and improve blood supply. But because of the low quality of the included studies, the curative effect cannot be confirmed, and more randomized controlled trials with high quality needs to be carried out in the future.

Citation： MinMin, XiongShixi. Meta Analysis of Dual-chamber Pacing and Ventricular Single-chamber Pacing for the Treatment of Cardiac Arrhythmia. West China Medical Journal, 2016, 31(8): 1338-1343. doi: 10.7507/1002-0179.201600367 Copy

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10.	郭萌. VVI和DDD起搏器治疗缓慢性心律失常的长期预后[D].大连:大连医科大学, 2009.
11.	盛晓东, 陆敏, 金骁琦, 等.不同起搏方式对起搏器植入患者的远期影响[J].临床荟萃, 2011, 26(22):1976-1978.
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13.	芮世宝.心室按需起搏与房室顺序生理性起搏对过缓性心律失常患者远期疗效的比较[J].皖南医学院学报, 2008, 27(4):268-269.
14.	徐长芬.单腔心室起搏与双腔起搏对缓慢性心律失常患者影响的比较研究[D].遵义:遵义医学院, 2010.
15.	张立权, 丁绍平, 胡东升, 等.心脏起搏对心动过缓患者心功能及房性心律失常的影响[J].心血管康复医学杂志, 2003, 12(3):209-211.
16.	鲜玉琼, 郑昌柱, 李莉, 等. DDD(R)与VVI(R)起搏模式对病窦综合征患者的影响[J].中国心脏起搏与心电生理杂志, 2011, 25(1):92-93.
17.	周燕燕, 鄢春喜.永久性心脏起搏器临床应用效果观察[J].现代中西医结合杂志, 2011, 20(7):814-815.
18.	徐海, 张启高. 306例患者不同心脏起搏模式影响的回顾性分析[J].医学研究生学报, 2011, 24(1):61-64.

1. 潘娅萍, 高彦, 吕云.双腔心脏起搏器对缓慢性心律失常患者心功能的疗效分析[J].中外医疗, 2013, 32(31):51-52.
2. 刘建荣, 喻立才.不同心脏起搏方式治疗严重缓慢性心律失常的临床观察[J].陕西中医学院学报, 2001, 24(3):24.
3. 庞胜, 王辉, 王挺, 等. 24例植入心脏起搏器患者临床分析[J].四川医学, 2008, 29(10):1330-1331.
4. 干春兰, 张永琼. 16例安置临时心脏起搏器的病人行胆道手术的护理[J].华西医学, 2007, 22(2):387.
5. Higgins JPT, Green S. Cochrane handbook for systematic reviews of interventions version 5.1.0[updated Macch 2011] [EB/OL]. The Cochrane Collaboration, 2011[2016-06-28]. www.cochrane-handbook.org.
6. 曾宪涛, 冷卫东, 李胜, 等.如何正确理解及使用GRADE系统[J].中国循证医学杂志, 2011, 11(9):985-990.
7. Dai M, Lu J, Qian DJ, et al. Assessment of left ventricular dyssynchrony and cardiac function in patients with different pacing modes using real-time three-dimensional echocardiography:comparison with tissue Doppler imaging[J]. Exp Ther Med, 2013, 6(5):1213-1219.
8. 董颖雪, 郭萌, 杨延宗, 等.不同起搏模式对缓慢性心律失常患者心脏重构及远期预后影响的随访观察[J].中华医学杂志, 2011, 91(30):2103-2107.
9. 彭亚飞, 钟玲, 丁燕生, 等. VVI与DDD对起搏术后患者心律失常的影响[J].中国心脏起搏与心电生理杂志, 2002, 16(1):28-30.
10. 郭萌. VVI和DDD起搏器治疗缓慢性心律失常的长期预后[D].大连:大连医科大学, 2009.
11. 盛晓东, 陆敏, 金骁琦, 等.不同起搏方式对起搏器植入患者的远期影响[J].临床荟萃, 2011, 26(22):1976-1978.
12. 周建龙, 朱宗成.不同起搏方式及右室起搏比例不同对缓慢型心律失常患者心功能及新发房颤影响的随访分析[J].齐齐哈尔医学院学报, 2014, 35(20):2103-2104.
13. 芮世宝.心室按需起搏与房室顺序生理性起搏对过缓性心律失常患者远期疗效的比较[J].皖南医学院学报, 2008, 27(4):268-269.
14. 徐长芬.单腔心室起搏与双腔起搏对缓慢性心律失常患者影响的比较研究[D].遵义:遵义医学院, 2010.
15. 张立权, 丁绍平, 胡东升, 等.心脏起搏对心动过缓患者心功能及房性心律失常的影响[J].心血管康复医学杂志, 2003, 12(3):209-211.
16. 鲜玉琼, 郑昌柱, 李莉, 等. DDD(R)与VVI(R)起搏模式对病窦综合征患者的影响[J].中国心脏起搏与心电生理杂志, 2011, 25(1):92-93.
17. 周燕燕, 鄢春喜.永久性心脏起搏器临床应用效果观察[J].现代中西医结合杂志, 2011, 20(7):814-815.
18. 徐海, 张启高. 306例患者不同心脏起搏模式影响的回顾性分析[J].医学研究生学报, 2011, 24(1):61-64.

West China Medical Journal

Meta Analysis of Dual-chamber Pacing and Ventricular Single-chamber Pacing for the Treatment of Cardiac Arrhythmia

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