左束支区域起搏对房室传导阻滞患者术后新发房性心律失常的影响  

Effect of left bundle branch area pacing on new⁃onset atrial arrhythmia after implantation

作　　者：张永旭 王岳松[2] 杨达 董学滨[2] 曹明勇[2] 汪韶君[2] 涂克祥 ZHANG Yongxu;WANG Yuesong;YANG Da;DONG Xuebin;CAO Mingyong;WANG Shaojun;TU Kexiang(Wannan Medical College,Wuhu 241002,China;不详)

机构地区：[1]皖南医学院,安徽芜湖241002 [2]马鞍山市人民医院心内科,安徽马鞍山243000

出　　处：《实用医学杂志》2024年第13期1846-1850,共5页The Journal of Practical Medicine

基　　金：马鞍山市科技计划项目(编号:YL2019-04)。

摘　　要：目的探讨左束支区域起搏(left bundle branch area pacing,LBBaP)对房室传导阻滞(AVB)患者术后新发心房颤动(new-onset atrial fibrillation,NOAF)和心房高频事件(atrial high rate episodes,AHREs)的影响。方法回顾性纳入84例行起搏治疗的三度房室传导阻滞(ⅢAVB)患者,根据心室电极位置分为LBBaP组(n=42)和右室间隔部起搏(RVSP)组(n=42)。比较两组患者术前术后QRS波时限(QRSd)、心室起搏参数,并发症、脑卒中事件和NOAF、AHREs发生率。结果(1)LBBaP组术后NOAF、AHREs发生率均低于RVSP组(P<0.05)。(2)LBBaP组的p-QRSd短于RVSP组(P<0.05)。(3)两组患者心室起搏参数、并发症及脑卒中事件发生率之间差异无统计学意义(P>0.05)。结论相对于右室起搏,LBBaP术后AHREs、NOAF的发生率较低,可改善患者预后。Objective To investigate the effect of left bundle branch area pacing(LBBaP)on new-onset atrial fibrillation(NOAF)and atrial high rate episodes(AHREs)in patients with atrioventricular block(AVB).Methods Eighty-four patients withⅢ°AVB for pacemaker implantaion were divided into the LBBaP group(n=42)and the RVSP group(n=42)based on the site of the ventricular leads.The two groupswere compared in terms of the pre-and post-operative QRSd,ventricular pacing parameters,complications,incidence of stroke,NOAF and AHREs.Results(1)The incidence of postoperative NOAF and AHREs in the LBBaP group was significantly lower compared with RVSP group(P<0.05).(2)The p-QRSd in the LBBaP group was significantly shorter compared with RVSP group(P<0.05).(3)The two groups showed no significant differences in ventricular pacing parameters,incidence of complications and stroke events(P>0.05).Conclusion LBBaP is superior to right ventricular pacing in reducing the incidence of postoperative AHREs and NOAF in patients after implantation and improving the prognosis of patients.

关 键 词：左束支区域起搏 右室起搏 心房颤动 心房高频事件 房室传导阻滞 

分 类 号：R541.75[医药卫生—心血管疾病]