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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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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16.	鮮玉瓊, 鄭昌柱, 李莉, 等. DDD(R)與VVI(R)起搏模式對病竇綜合征患者的影響[J].中國心臟起搏與心電生理雜志, 2011, 25(1):92-93.
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18.	徐海, 張啟高. 306例患者不同心臟起搏模式影響的回顧性分析[J].醫學研究生學報, 2011, 24(1):61-64.

1. 潘婭萍, 高彥, 呂云.雙腔心臟起搏器對緩慢性心律失常患者心功能的療效分析[J].中外醫療, 2013, 32(31):51-52.
2. 劉建榮, 喻立才.不同心臟起搏方式治療嚴重緩慢性心律失常的臨床觀察[J].陜西中醫學院學報, 2001, 24(3):24.
3. 龐勝, 王輝, 王挺, 等. 24例植入心臟起搏器患者臨床分析[J].四川醫學, 2008, 29(10):1330-1331.
4. 干春蘭, 張永瓊. 16例安置臨時心臟起搏器的病人行膽道手術的護理[J].華西醫學, 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. 曾憲濤, 冷衛東, 李勝, 等.如何正確理解及使用GRADE系統[J].中國循證醫學雜志, 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. 董穎雪, 郭萌, 楊延宗, 等.不同起搏模式對緩慢性心律失常患者心臟重構及遠期預后影響的隨訪觀察[J].中華醫學雜志, 2011, 91(30):2103-2107.
9. 彭亞飛, 鐘玲, 丁燕生, 等. VVI與DDD對起搏術后患者心律失常的影響[J].中國心臟起搏與心電生理雜志, 2002, 16(1):28-30.
10. 郭萌. VVI和DDD起搏器治療緩慢性心律失常的長期預后[D].大連:大連醫科大學, 2009.
11. 盛曉東, 陸敏, 金驍琦, 等.不同起搏方式對起搏器植入患者的遠期影響[J].臨床薈萃, 2011, 26(22):1976-1978.
12. 周建龍, 朱宗成.不同起搏方式及右室起搏比例不同對緩慢型心律失常患者心功能及新發房顫影響的隨訪分析[J].齊齊哈爾醫學院學報, 2014, 35(20):2103-2104.
13. 芮世寶.心室按需起搏與房室順序生理性起搏對過緩性心律失常患者遠期療效的比較[J].皖南醫學院學報, 2008, 27(4):268-269.
14. 徐長芬.單腔心室起搏與雙腔起搏對緩慢性心律失常患者影響的比較研究[D].遵義:遵義醫學院, 2010.
15. 張立權, 丁紹平, 胡東升, 等.心臟起搏對心動過緩患者心功能及房性心律失常的影響[J].心血管康復醫學雜志, 2003, 12(3):209-211.
16. 鮮玉瓊, 鄭昌柱, 李莉, 等. DDD(R)與VVI(R)起搏模式對病竇綜合征患者的影響[J].中國心臟起搏與心電生理雜志, 2011, 25(1):92-93.
17. 周燕燕, 鄢春喜.永久性心臟起搏器臨床應用效果觀察[J].現代中西醫結合雜志, 2011, 20(7):814-815.
18. 徐海, 張啟高. 306例患者不同心臟起搏模式影響的回顧性分析[J].醫學研究生學報, 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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