摘要
目的评估左束支起搏心脏再同步化治疗(LBBP CRT)对心力衰竭(下称心衰)伴希氏束起搏(HBP)不能纠正的完全性左束支传导阻滞(CLBBB)患者的疗效。方法选择2020年1月至11月浙江省台州医院行LBBP CRT的心衰伴HBP不能纠正的CLBBB患者6例。采集12导联心电图评估术前术后电同步性,采用超声心动图评估起搏时及停止起搏10 min后机械同步性[左心室12节段心肌收缩峰值速度时间标准差(Tsd-12-LV)、心室间机械延迟(IVMD)],比较术前及术后6个月纽约心脏病协会(NYHA)心功能分级及超声心动图指标。结果6例患者术后QRS时间(124.5±5.7)ms,与术前QRS时间(162.8±17.0)ms比较,差异有统计学意义(P<0.05)。起搏时Tsd-12-LV为(41.5±7.6)ms,IVMD为(19.5±5.9)ms,与停止起搏10 min后[(58.7±15.8)ms,(50.0±9.3)ms]比较,差异均有统计学意义(均P<0.05)。术后6个月,NYHA心功能分级较术前改善(P<0.05)。结论LBBP CRT对心衰伴HBP不能纠正的CLBBB患者有一定疗效。
Objective To evaluate the effect of left bundle branch pacing(LBBP)for cardiac resynchronization therapy(CRT)on heart failure patients with His bundle pacing(HBP)uncorrected complete left bundle branch block(CLBBB).Methods A total of 6 heart failure patients underwent LBBP-CRT after HBP failed to correct CLBBB in Taizhou Hospital of Zhejiang Province from January to November 2020 were selected.Electrical synchrony was measured on 12-lead electrocardiogram before and after the operation.Mechanical synchrony was evaluated by Doppler echocardiography during LBBP and 10 minutes after stopping LBBP.The NYHA class and echocardiographic parameters before and 6 months after the operation were compared.Results The postoperative QRS duration was(124.5±5.7)ms,which was significantly different from preoperative QRS duration(162.8±17.0)ms(P<0.05).The standard deviation of time-to-peak contraction velocity in 12 left ventricular segments was(41.5±7.6)ms and interventricular mechanical delay was(19.5±5.9)ms during pacing,which were significantly different from those 10 min later after pacing was stopped[(58.7±15.8)ms,(50.0±9.3)ms](P<0.05).NYHA class was improved 6 months later after the operation than before the operation(P<0.05)Conclusion LBBP-CRT has a certain effect on patients with heart failure and CLBBB uncorrected with HBP.
作者
程颖
杨性安
卢先本
CHENG Ying;YANG Xing'an;LU Xianben(Department of Cardiology,Taizhou Hospital of Zhejiang Province,Taizhou 317000,China)
出处
《心电与循环》
2022年第5期425-430,435,共7页
Journal of Electrocardiology and Circulation
基金
浙江省医药卫生科技计划项目(2019KY775)
台州市科技计划项目(21ywa16)。
关键词
希氏束
心脏再同步治疗
束支传导阻滞
His bundle
Cardiac resynchronization therapy
Bundle branch block
