伴右束支传导阻滞者左束支区域起搏的最佳房室间期选择  

Effect of right bundle branch block on the optimal atrioventricular delay of left bundle branch area pacing

作　　者：赵若寒 邓晓奇[1] 王淑珍[1] 刘春霞[1] 张丽娟[1] 徐敏[1] 黄晓凤 谭焜月 严霜霜 熊峰[1] ZHAO Ruohan;DENG Xiaoqi;WANG Shuzhen;LIU Chunxia;ZHANG Lijuan;XU Min;HUANG Xiaofeng;TAN Kunyue;YAN Shuangshuang;XIONG Feng(Department of Cardiology,Cardiovascular Institute of Chengdu,The Third Peoples Hospital of Chengdu,Chengdu,610000,China)

机构地区：[1]成都市第三人民医院心内科成都市心血管病研究所,成都610000

出　　处：《临床心血管病杂志》2020年第9期844-849,共6页Journal of Clinical Cardiology

基　　金：四川省科技厅课题基金项目(No:2018JY0385)。

摘　　要：目的:探讨右束支传导阻滞对左束支区域起搏最佳房室间期的影响。方法:纳入19例行左束支区域起搏的患者,术前采集心电图明确束支传导阻滞情况,术后在超声心动图指导下获取最佳房室间期,比较不同房室间期下所获取的超声参数差异及右束支阻滞对于房室间期选择的影响。结果:通过超声心动图优化房室间期,可使心脏血流动力学最优化;术前伴右束支阻滞患者的最佳房室间期短于不伴右束支阻滞者(P<0.05)。结论:左束支区域起搏是一种可行性高的生理性起搏方式,房室间期的选择可影响行左束支区域起搏患者的血流动力学状态,最佳房室间期的选择具有个体差异性,右束支传导阻滞可能影响最佳房室间期的选择。Objective:To observe the effects of right bundle branch block on the selection of optimal atrioventricular delay for left bundle branch area pacing.Method:In 19 patients undergoing left bundle branch area pacing,electrocardiogram was collected before the operation to specify the bundle branch block,and the optimal atrioventricular delay was obtained under the guidance of echocardiography.The differences of ultrasonic parameters obtained under different atrioventricular delay were compared and the influence of right bundle branch block on the selection of atrioventricular delay was discussed.Result:Echocardiography can optimize the cardiac hemodynamics by optimizing the atrioventricular delay.The optimal atrioventricular delay in patients with preoperative right bundle branch block were shorter than those without right bundle branch block(P<0.05).Conclusion:Left bundle branch area pacing is a physiological pacing method with high feasibility.Atrioventricular delay can affect the hemodynamic status of patients undergoing left bundle branch area pacing.The selection of the optimal atrioventricular delay has individual difference.Preoperative right bundle branch block may affect the selection of optimal atrioventricular delay.

关 键 词：左束支区域起搏 生理性起搏 房室间期 右束支传导阻滞 

分 类 号：R541.7[医药卫生—心血管疾病]