经胸超声心动图评估左束支区域起搏器植入术后安全性及有效性的初步探索  

Safety and effectiveness of transthoracic echocardiography in left bundle branch area pacing surgery with a new type of pacemaker

作　　者：田园[1] 赵悦 宋昆鹏[2] 李广华 焦莹 TIAN Yuan;ZHAO Yue;SONG Kun-peng;LI Guang-hua;JIAO Ying(Department of Ultrasound Medicine,Zhengzhou Central Hospital,Zhengzhou 450000,China;Department of Cardiovascular Medicine,Zhengzhou Central Hospital,Zhengzhou 450000,China)

机构地区：[1]郑州市中心医院超声医学科,郑州450000 [2]郑州市中心医院心血管内科,郑州450000

出　　处：《医药论坛杂志》2024年第9期996-999,共4页Journal of Medical Forum

摘　　要：目的探讨经胸超声心动图在新型起搏器行左束支区域起搏术后的安全性及有效性。方法回顾性收集2023年2月至2023年12月于郑州市中心医院应用新型起搏器成功行左束支区域起搏患者11例,统计性别、年龄、病因等基本病例资料及常规超声心动图参数,应用2D-STI获得左心室6节段左室短轴前间隔与后壁收缩期径向应变达峰时间差、径向应变达峰时间标准差、左心室17节段峰值应变离散度、收缩期纵向应变达峰时间最大差值。结果采用病例报告表展示纳入患者观察指标结果,11例患者术后3天超声检查未见室间隔血肿、室间隔穿孔、起搏器导线移位、断裂等并发症,静息态心功能测值未见减低,1例患者见少量心包积液,所有患者均存在不同程度三尖瓣反流,所有患者术后左心室内同步性良好。结论新型起搏器应用于左束支区域起搏是安全可靠的,经胸超声心动图可用于观察和评估植入术后导线的位置及左心室内同步性等情况,值得临床推广。Objective To explore the safety and effectiveness of transthoracic echocardiography in the left bundle branch area pacing surgery with a new type of pacemaker.Methods A retrospective study was conducted on ll patients who successfully performed left bundle branch pacing using a new pacemaker in our hospital from February 2023 to December 2023.Basic case data such as gender,age,etiology,and conventional echocardiogram parameters were collected.2D-STI was used to obtain the maximum difference in peak time of longitudinal strain in 17 segments of the left ventricle during systole,peak strain dispersion,and standard deviation of radial strain peak time in 6 segments of the left ventricle The time difference between the peak radial strain of the left ventricular short axis anterior septum and posterior wall during systole.Results All cases were reported by charts according to International Case Report Rules.Eleven patients showed no complications such as ventricular septal hematoma,ventricular septal perforation,wire displacement,or rupture on ultrasound examination 3 days after surgery,and no decrease in resting state cardiac function measurement was observed.One patient showed a small amount of pericardial effusion,and all patients had varying degrees of tricuspid regurgitation.Postoperative left ventricular synchrony was good in all patients.Conclusion The application of a new pacemaker in pacing the left bundle branch area is safe and reliable.Transthoracic echocardiography can be used to observe the position of the implanted lead and left ventricular synchrony after implantation,and is worthy of clinical promotion.

关 键 词：超声心动图 左束支区域起搏 同步性 起搏器植入 

分 类 号：R540.45[医药卫生—心血管疾病]