左束支解剖结构对左束支区域起搏的临床指导意义  

Clinical Significance of Anatomical Structure of Left Bundle Branch on Left Bundle Branch Area Pacing

作　　者：谢小霜 范洁 XIE Xiaoshuang;FAN Jie(Dali University,Dali 671000,Yunnan,China;Department of Cardiology,The First People's Hospital of Yunnan Province,Kunming 650100,Yunnan,China)

机构地区：[1]大理大学,云南大理671000 [2]云南省第一人民医院心血管内科,云南昆明650100

出　　处：《心血管病学进展》2020年第11期1196-1198,1208,共4页Advances in Cardiovascular Diseases

基　　金：云南省科技厅-昆明医科大学应用基础研究[2019FE001(-291)]。

摘　　要：希氏束穿透束沿室间隔膜部后下缘下行,走行于无冠窦和右冠窦交界的下方分出左束支沿左室间隔面再向下,左束支大多分为两束,其间有交叉呈扇形分布于左室间隔心内膜下。研究发现,大部分完全性左束支传导阻滞可在左束支区域起搏低起搏阈值输出下得到纠正,对于症状缓慢型心律失常和三度房室传导阻滞等患者同样具有很好的疗效。为提高左束支区域起搏手术植入成功率,了解左束支区域的解剖及解剖结构变化对于成功的左束支区域起搏显得至关重要。现就左束支的解剖特征对左束支区域起搏临床应用的指导意义做一综述。The His bundle went down along the posterior lower margin of the interventricular septum,and went below the junction between the right and no coronary sinus,and separated left bundle branch went down along the left ventricular septal surface.The left bundle branch was mostly divided into two fasciculus.There was a cross fan-shaped distribution under the endocardium of the interventricular septum.Studies have found that most complete left bundle-branch block can be corrected under the low pacing threshold output of left bundle branch area pacing,which also has good efficacy for patients with symptoms such as bradyarrhythmia and third degree atrioventricular block.In order to improve the success rate of implantation in left bundle branch region,it is very important to understand the anatomy and structural changes of left bundle branch area for successful left bundle branch area pacing.This article reviews the significance of the anatomical features of the left bundle branch in guiding the clinical application of the left bundle branch area pacing.

关 键 词：左束支解剖 左束支区域起搏 生理性起搏 

分 类 号：R541.7[医药卫生—心血管疾病]