左束支电位影响左束支起搏心电图参数的系统评价和Meta分析  

Impact of Left Bundle Branch Potential on the Characteristics of the Electrocardiogram During Left Bundle Branch Pacing:a Systematic Literature Review and Meta-analysis

作　　者：尹磊 耿雪[1] 刘倩[1] 何长健 谢瑞芹 YIN Lei;GENG Xue;LIU Qian;HE Changjian;XIE Ruiqin(Department of Cardiology,The Second Hospital of Hebei Medical University,Shijiazhuang(050000),Hebei,China)

机构地区：[1]河北医科大学第二医院心内科,河北省石家庄市050000

出　　处：《中国循环杂志》2021年第11期1121-1126,共6页Chinese Circulation Journal

基　　金：河北省政府资助专科能力建设和专科带头人培养项目(361004)。

摘　　要：目的:通过心电图参数,评价左束支电位的存在与否对左束支起搏的电同步性、起搏器感知以及起搏阈值的影响。方法:检索2014年1月至2021年4月PubMed、Embase、Web of science以及Cochrane图书馆发表的所有文献。对文章进行筛选及提取,用纽卡斯尔-渥太华(NOS)量表对纳入的队列研究进行质量评价,同时采用Review Manager 5.4、Stata 15.0软件进行Meta分析。结果:纳入11项研究,共613例患者。Meta分析显示,有左束支电位的左束支起搏相较于无左束支电位的左束支起搏有更短的起搏QRS间期(MD=-7.27;95%CI:-11.94~-2.59,P=0.002)和左心室激动时间(MD=-5.55,95%CI:-8.34~-2.77,P<0.0001)。R波振幅(MD=0.93,95%CI:-0.38~2.24,P=0.16)以及起搏阈值(MD=-0.09,95%Cl:-0.39~0.20,P=0.54)的差异无统计学意义。结论:在电同步性上,有左束支电位的左束支起搏优于无左束支电位的左束支起搏,而在起搏器感知以及起搏阈值方面两者没有差异。Objectives:The electrocardiogram parameters were used to systematically evaluate the influence of the left bundle branch potential on the electrical synchronization of left bundle branch pacing,sensing amplitude and capture threshold.Methods:The related literatures were obtained from Pubmed,Embase,Cochrane Library beginning from 2014 to April 2021.The literatures were screened according to inclusion and exclusion criteria,and the quality of the included cohort students was evaluated with NOS scale.RevMan 5.4 and Stata 15.0 software were used for Meta-analysis.Results:Eleven studies were included with a total of 613 patients.The results of the Meta-analysis showed that left bundle branch pacing with left bundle branch potential resulted in significantly shorter QRS duration(MD=-7.27;95%CI:-11.94 to-2.59,P=0.002)and left ventricular activation time(MD=-5.55,95%CI:-8.34 to-2.77,P<0.0001)than left bundle branch pacing without left bundle branch potential.There was no significant difference in R-wave amplitude(MD=0.93,95%CI:-0.38 to 2.24,P=0.16)and pacing threshold(MD=-0.09,95%Cl:-0.39 to 0.20,P=0.54)between left bundle branch pacing with or without left bundle branch potential.Conclusions:Left bundle branch pacing with left bundle branch potentials is superior to left bundle branch pacing without left bundle branch potentials in terms of electrical synchronization,but sensing amplitude and capture threshold are not affected by the absence or presence of left bundle branch potentials.

关 键 词：左束支电位 左束支起搏 心电图 系统评价 META分析 

分 类 号：R54[医药卫生—心血管疾病]