左束支区域起搏与右心室低位间隔部起搏对永久性心脏起搏器植入术患者心功能影响的对比研究  

Comparative Study of Effect of Left Bundle Branch Pacing and Right Ventricular Low Interval Pacing on Cardiac Function in Patients with Permanent Pacemaker Implantation

作　　者：黄於娟[1] 孙立平[1] 蒋芳勇[1] 朱川萌 HUANG Yujuan;SUN Liping;JIANG Fangyong;ZHU Chuanmeng(Department of Cardiovascular Medicine,Liuzhou People's Hospital,Liuzhou 545000,China)

机构地区：[1]广西壮族自治区柳州市人民医院心血管内科,545000

出　　处：《实用心脑肺血管病杂志》2021年第3期68-74,共7页Practical Journal of Cardiac Cerebral Pneumal and Vascular Disease

基　　金：广西壮族自治区卫生健康委员会自筹经费科研课题(Z20190064)。

摘　　要：背景目前希氏束起搏(HBP)被公认为是最符合生理要求的起搏方式,但其阈值高、电池寿命短,适应证严格,存在一定局限性,因此探寻更理想的符合生理性起搏的起搏方式具有重大意义。目的比较左束支区域起搏(LBBP)与右心室低位间隔部起搏对永久性心脏起搏器植入术患者心功能的影响,以为LBBP作为更为理想的生理性起搏方式提供依据。方法选取2019年7月—2020年3月柳州市人民医院心血管内科收治的30例行永久性心脏起搏器植入术患者作为研究对象,根据心脏起搏电极植入部位不同分为对照组和观察组,各15例。对照组患者术中进行右心室低位间隔部起搏,观察组患者术中进行LBBP。比较两组患者术前及术后1、6、12个月各心腔大小(包括右心房横径、右心房长径、右心室前后径、右心室横径、左心房前后径、左心房横径、左心房长径、左心室舒张末期前后径、左心室舒张末期横径)、瓣膜反流面积〔包括左、右房室瓣反流束的缩流颈(VC)〕、左心室射血分数(LVEF)、N末端脑钠肽前体(NT-proBNP)水平,比较两组患者不良预后发生情况。结果(1)方法与时间在右心房横径、右心房长径、右心室前后径、右心室横径、左心房前后径、左心房横径、左心房长径、左心室舒张末期前后径、左心室舒张末期横径上不存在交互作用(P>0.05)。方法在右心房横径、右心房长径、右心室前后径、右心室横径、左心房长径上主效应不显著(P>0.05);方法在左心房前后径、左心房横径、左心室舒张末期前后径、左心室舒张末期横径上主效应显著(P<0.05)。时间在右心房横径、右心房长径、右心室前后径、右心室横径、左心房横径、左心房长径、左心室舒张末期横径上主效应不显著(P>0.05);时间在左心房前后径、左心室舒张末期前后径上主效应显著(P<0.05)。观察组患者术后6、12个月左心室舒�Backgroud His bundle pacing(HBP)is the most physiological pacing method,however,this method has its limitations for its high threshold,short battery life and limited indications.Therefore,it is of great significance and necessity to explore a more ideal pacing method.Objective To compare the effect of left bundle branch pacing(LBBP)and right ventricular lower septum pacing on cardiac function in patients implanted with permanent cardiac pacemaker,in order to provide basis for IBBP as a more ideal pacing method.Methods Thirty patients implanted with permanent cardiac pacemaker,admitted to the Department of Cardiovascular Medicine,Liuzhou People's Hospital from July 2019 to March 2020,were selected as objects,they were divided into control group and observation group according to the location of cardiac pacing electrode implantation,15 cases in each group.Patients in control group was paced at the lower right ventricular septum while patients in observation group was paced at LBBP.Size of each heart chamber(including right atrium transverse diamete,right atrial long diameter,right ventricular anteroposterior diameter,right ventricular transverse diameter,left atrium anteroposterior diameter,left atrial transverse diameter,left atrial long diameter,left ventricular end diastolic anteroposterior diameterleft ventricular end diastolic transverse diameter),valve regurgitation area〔including left atrioventricular valve,right atrioventricular valve regurgitant systolic neck(VC)〕,left ventricular ejection fraction(LVEF),N-terminal probrain natriuretic peptide(NT-proBNP)before operation and 1,6,12 months after operation were compared between the two groups.The incidence of poor prognosis was compared between the two groups.Results(1)There was no interaction between method and time on right atrium transverse diamete,right atrial long diameter,right ventricular anteroposterior diameter,right ventricular transverse diameter,left atrium anteroposterior diameter,left atrial transverse diameter,left atrial long diameter,left

关 键 词：束支传导阻滞 右心室低位间隔部起搏 心脏起搏器 心功能 

分 类 号：R541.76[医药卫生—心血管疾病]