通过右室造影直接定位左束支区域起搏的初步研究  

Preliminary study of left bundle branch area pacing directly locating by right ventriculography

作　　者：杨桂强[1] 雷敏[1] 黎伟[1] 吕海权 陆敏[1] 刘艳丽[2] YANG Gui-qiang;LEI Min;LI Wei;LV Hai-quan;LU Min;LIU Yang-li(Department of Cardiology,Red Cross Hospital of Yulin City 537000,Guangxi,China;Department of Geriatric Cardiology of the First Affiliated Hospital of Guangxi Medical University,Nanning 530021,Guangxi,China)

机构地区：[1]广西玉林市红十字会医院心血管内科,广西玉林537000 [2]广西医科大学第一附属医院老年心血管内科,广西南宁530021

出　　处：《中国心脏起搏与心电生理杂志》2020年第5期451-454,共4页Chinese Journal of Cardiac Pacing and Electrophysiology

摘　　要：目的通过右室造影方法直接定位左束支区域起搏电极的植入部位,探讨能更快速准确的植入起搏器的方法。方法入选符合植入永久起搏器指征的10例患者,先送入SelectSite His C315鞘(Medtronic公司,美国)至右室流入道行右室造影,根据造影确定瓣环及三尖瓣环顶部,顶部往心尖方向约1.5~2cm处即为电极的植入部位,送入3830电极至左束支区域后调整到位,测量各种起搏参数。结果通过解剖位置快速定位,尝试旋拧电极1~2次即可植入电极至左束支区域,起搏QRS波宽度(115±10)ms,夺获阈值(1.0±0.2)V。8例可见P电位,无并发症。结论通过右室造影获取解剖位置可直接定位左束支区域起搏电极的植入部位,具有良好的可操作性,安全、有效。Objective To explore the method which can implant the pacemaker more accurately and quickly in the left bundle branch area by right ventriculography.Methods Ten patients who were eligible for implantation of permanent pacemaker were enrolled.C315His Sheath(Medtronic,United States)was delivered to the right ventricular inflow tract through right ventriculography.The 3830pacing lead was then advanced to the tip of the sheath,and the electrograms from this lead were simultaneously to adjust.Results All pacing parameters were standard in the left bundle branch area through right ventriculography.Conclusion Obtaining the anatomical position by right ventriculography can directly locate the implantation site of the left bundle branch region which is safe and effective.

关 键 词：心血管病学 右室造影 左束支区域起搏 三尖瓣环 

分 类 号：R318.11[医药卫生—生物医学工程]