摘要
心脏再同步化治疗(CRT)是心力衰竭伴有左心室射血分数减低和电-机械运动不同步患者除药物治疗外的标准治疗手段之一.临床实践中发现传统CRT(即双心室起搏治疗)有许多不足,近些年来出现的希氏束起搏(HBP)以及左束支区域起搏(LBBaP)均为生理性起搏,统称希浦系统起搏(HPSP).研究显示,HPSP可同时达到心脏电-机械同步化,进而实现心力衰竭患者CRT.与传统CRT相比,HPSP-CRT具有较高的价-效比,是心力衰竭患者理想选择之一;对于经济困难心力衰竭患者,甚或可以作为CRT首选.本文将就HPSP的研究进展进行综述.
Cardiac resynchronization therapy(CRT)is one of the standard treatments for patients with heart failure(HF)and reduced left ventricular ejection fraction and cardiac electro-mechanical dyssynchrony besides medication.It was found there were many shortcomings for classical CRT(bi-ventricular pacing,BiV-CRT)after years of clinical practice.Nearly two decades,it was confirmed that His bundle pacing(HBP)was a safe and effective method to restore the dyssynchronized heart.Meanwhile,left bundle branch area pacing(LBBaP)initially reported about 3 year ago had the similar function.Both HBP and LBBaP belong to strategy of physiological pacing and collectively referred to as His-Purkinje system pacing(HPSP).Compared with BiV-CRT,there were many advantages in HPSP-CRT.HBSP-CRT could even be the first choice of CRT for HF patients with financial difficulties.Herein,we will review the progress in the researches on HPSP-CRT.
作者
张俊蒙
王泽峰
张健
吴永全
Zhang Junmeng;Wang Zefeng;Zhang Jian;Wu Yongquan(Department of Cardiology,Beijing Anzhen Hospital Affiliated to Capital Medical University,Beijing Institute of Cardiovascular and Pulmonary Vascular Disease,Beijing 100029,China;Heart Failure Center,Fuwai Hospital,Chinese Academy of Medical Science&Peking Union Medical College,National Key Laboratory of Cardiovascular Disease,Beijing 100037,China)
关键词
心力衰竭
心脏再同步化治疗
希浦系统起搏
Heart failure
Cardiac resynchronization therapy
His-Purkinje system pacing
