继续探寻生理性起搏  

Continued Search for Physiological Pacing

作　　者：刘宇博 栾颖[1,2] LIU Yubo 1 ,LUAN Ying 1,2(1.Harbin Medical University Graduate School,Harbin 150000,Heilongjiang,China; 2.Department of Cardiology,The Second Affiliated Hospital of Harbin Medical University,Harbin 150000,Heilongjiang,Chin)

机构地区：[1]哈尔滨医科大学研究生院,黑龙江哈尔滨150000 [2]哈尔滨医科大学附属第二医院心血管内科,黑龙江哈尔滨150000

出　　处：《心血管病学进展》2018年第5期799-802,共4页Advances in Cardiovascular Diseases

摘　　要：心脏起搏是由窦房结功能障碍或房室传导阻滞导致心动过缓患者的有效治疗措施。尽管随着几十年来技术的进步,但模拟正常人体心脏生理的理想心室起搏部位仍是个难题。以心房同步右室心尖部起搏开始,继而至可代替右室的起搏位点,如双心室起搏、左心室起搏,以及希氏束起搏。现综述现有起搏方案的地位,并特别关注希氏束起搏。左室同步起搏、左室多部位起搏、左室心内膜起搏作为新颖的起搏方案为部分患者提供了新的希望。Cardiac pacing is an effective treatment for patients with bradycardia caused by sinus node dysfunction or atrioventricular block.Despite decades of technological advances,the optimal ventricular pacing sites that mimic normal human ventricular physiology and best hemodynamic response remains elusive.Beginning with atrial synchronous right ventricular（RV）apical pacing,the search has continued through alternate RV pacing sites,minimizing RV pacing,biventricular pacing,left ventricular（LV）pacing,and His-bundle pacing.Understanding the deleterious effects of long-term RV apical pacing in vulnerable populations has created tremendous interest in alternate pacing options.This paper reviews the current status of available pacing options,with particular focus on His-bundle pacing.Synchronized LV pacing,multisite LV pacing,and LV endocardial pacing offer promise as novel pacing options in select patients.

关 键 词：生理性起搏 双心室起搏 希氏束起搏 左室多部位起搏 左室心内膜起搏 

分 类 号：R541.7[医药卫生—心血管疾病]