摘要
目的:应用超声心动图评估左束支区域起搏(LBBP)电极位置及安全性。方法:入选2018年10月至2019年5月我院行LBBP患者122例,其中起搏器植入86例(起搏器组),左束支再同步(L-CRT)植入36例(L-CRT组)。术前及术后3个月对其临床症状、起搏器程控以及超声心动图指标进行记录和随访。结果:术后3个月超声心动图检查显示,电极无明显移位,无室间隔血肿、室间隔穿孔等并发症。起搏器组和L-CRT组电极旋入深度分别为(10.1±1.4)mm和(9.6±1.7)mm,电极旋入点至三尖瓣隔叶根部距离分别为(20.9±3.8)mm和(24.3±6.2)mm,电极旋入点距主动脉右冠瓣距离分别为(10.3±2.4)mm和(10.5±3.9)mm,差异均无统计学意义(P均>0.05)。起搏器组和L-CRT组分别有8例和2例患者三尖瓣反流量较术前增加,但均为少量至少中量。所有患者植入电极均无明显限制三尖瓣活动表现。结论:LBBP短期随访起搏电极位置及安全性良好。
Objectives:We aimed to prospectively evaluate the lead position and lead safety of left bundle branch pacing(LBBP)with echocardiography.Methods:In this study,a total of 122 patients,who received pacing and cardiac resynchronization therapy(L-CRT)treatment from October 2018 to May 2019 in our center were included(86 pacing cases and 36 L-CRT cases).Clinical symptoms,pacemaker control and echocardiography parameters before and three months after operation were analyzed.Results:Echocardiography performed at 3 months post implantation showed there were neither significant displacement of the lead nor complications such as ventricular septal hematoma and ventricular septal perforation.The electrode depth was(10.1±1.4)mm in the pacemaker group and(9.6±1.7)mm in L-CRT group(P>0.05);the distance from the electrode screw point to the base of tricuspid valve leaflet was(20.9±3.8)mm in the pacemaker group and(24.3±6.2)mm in the L-CRT group(P>0.05);and the distance from the electrode screw point to the right coronary valve was(10.3±2.4)mm in the pacemaker group and(10.5±3.9)mm in the L-CRT group(all P>0.05).Compared with the preoperative data,the tricuspid regurgitation was slightly increased in 8 patients post pacemaker implantation and in 2 patients post L-CRT.The tricuspid valve movement was not affected post lead implantation with pacemaker or L-CRT.Conclusions:Echocardiographic follow-up results show that the leads of LBBP are well positioned and safe during the short-term follow-up in this patient cohort.
作者
李慧
李晓飞
樊晓寒
齐红霞
王江涛
刘偈
王浩
逄坤静
LI Hui;LI Xiaofei;FAN Xiaohan;QI Hongxia;WANG Jiangtao;LIU Jie;WANG Hao;PANG Kunjing(Department of Ultrasound,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)
出处
《中国循环杂志》
CSCD
北大核心
2020年第8期761-764,共4页
Chinese Circulation Journal
基金
中央高校基本科研业务费专项资金资助(3332018051)。
关键词
心脏起搏
左束支区域
心脏再同步化治疗
超声心动图
pacemaker
left bundle branch area
cardiac resynchronization therapy
echocardiography
