摘要
目的探讨左束支区域起搏(LBBaP)在三度房室传导阻滞(AVB)患者中应用的可行性、安全性,以及与右室间隔起搏(RVSP)相比较的具体优势。方法该研究为单中心回顾性病例分析。选取2020年9月至2022年1月因三度AVB于该院住院并具备永久起搏治疗适应证的患者56例,26例行LBBaP,30例行RVSP,比较2组患者术前、术后心电图QRS波宽度;心脏彩色多普勒超声测定2组患者术前,术后3、6个月左心房前后径(LAAD)、左心室舒张末期前后径(LVEDD)和左室射血分数(LVEF);程控仪测定2组患者术中,术后3、6个月心室电极参数;比较2组患者术前,术后1周,术后1、3、6个月的N末端B型利钠肽前体(NT-proBNP)值;统计2组患者术后并发症发生情况。结果术后LBBaP组患者QRS波宽度窄于RVSP组,差异有统计学意义(P<0.001)。2组患者阈值、感知、阻抗均在正常范围内,LBBaP组术后无阈值增高现象。LBBaP组患者术后6个月LAAD和LVEDD低于RVSP组,LBBaP组患者术后6个月LVEF高于RVSP组,差异均有统计学意义(P<0.05)。术后3个月时,LBBaP组患者NT-proBNP值低于RVSP组,术后6个月时差别进一步扩大,差异均有统计学意义(P<0.05)。2组患者并发症发生率比较,差异无统计学意义(P>0.05)。结论与RVSP相比,LBBaP是一种更理想且安全的生理性起搏方式。
Objective To investigate the feasibility,safety,and specific advantages of left bundle branch area pacing(LBBaP)in patients with third-degree atrioventricular block(AVB)compared with right ventricular septal pacing(RVSP).Methods The study was a single-center retrospective case analysis.From September 2020 to January 2022,a total of 56 patients with third-degree AVB and with permanent pacing indications were selected,26 patients were treated with LBBaP and 30 patients with RVSP.The QRS wave width of ECG before and after operation was compared in both groups.Left atrial anteroposterior diameter(LAAD),left ventricular end-diastolic anteroposterior diameter(LVEDD)and left ventricular ejection fraction(LVEF)were measured by cardiac color doppler ultrasound before and three and six months after operation in both groups.The parameters of ventricular electrodes were measured by programmable instrument during operation and three and six months after operation in both groups.The values of N-terminal pro-B-type natriuretic peptide(NT-proBNP)were compared before operation,one week after operation and one,three and six months after operation in both groups.The postoperative complications of two groups were analyzed.Results QRS wave width in the LBBaP group was narrower than that in the RVSP group after operation,and the difference was statistically significant(P<0.001).The threshold,perception and impedance of the two groups were within the normal range,and there was no increase in threshold in the LBBaP group after operation.The LAAD and LVEDD in the LBBaP group were lower than those in the RVSP group at six months after operation,and LVEF in the LBBaP group was higher than that in the RVSP group at six months after operation,with statis-tical significance(P<0.05).The value of NT-proBNP in the LBBaP group was lower than that in the RVSP group at three months after operation,and the difference was further enlarged at six months after operation,with statistical significance(P<0.05).There was no significant difference in the in
作者
石明明
黄贤胜
王虹
李舒承
王晓晓
王青松
张娜
高海超
梁浩
SHI Mingming;HUANG Xiansheng;WANG Hong;LI Shucheng;WANG Xiaoxiao;WANG Qingsong;ZHANG Na;GAO Haichao;LIANG Hao(Department of Cardiology,the South Hospital of the Affiliated Hospital of Chengde Medical College,Chengde,Hebei 067000,China)
出处
《现代医药卫生》
2023年第17期2949-2954,2959,共7页
Journal of Modern Medicine & Health
关键词
房室传导阻滞
心脏起搏
人工
左束支区域起搏
右室间隔起搏
Atrioventricular block
Cardiac pacing
Artificial
Left atrial anteroposterior diame-ter
Right ventricular septal pacing
