[1]林杰 李海瑞 李海鹰.左束支区域起搏的现状和展望[J].心血管病学进展,2020,(5):462-467.[doi:10.16806/j.cnki.issn.1004-3934.2020.05.006]
 LIN Jie,LI Hairui,LI Haiying.Present and Future of Left Bundle Branch Area Pacing[J].Advances in Cardiovascular Diseases,2020,(5):462-467.[doi:10.16806/j.cnki.issn.1004-3934.2020.05.006]
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左束支区域起搏的现状和展望()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2020年5期
页码:
462-467
栏目:
出版日期:
2020-05-25

文章信息/Info

Title:
Present and Future of Left Bundle Branch Area Pacing
作者:
林杰 李海瑞 李海鹰
(深圳大学总医院心内科,广东 深圳 518055)
Author(s):
LIN Jie LI Hairui LI Haiying
(Shenzhen University General Hospital ,Shenzhen 518055,Guangdong,China)
关键词:
希氏束起搏左束支区域起搏生理性起搏心脏再同步化治疗
Keywords:
His bundle pacing Left bundle branch area pacing Physiological pacing Cardiac resynchronization therapy
DOI:
10.16806/j.cnki.issn.1004-3934.2020.05.006
摘要:
希氏束和左束支区域的生理性起搏较右室心尖部起搏明显改善心脏的电机械同步性,改善心功能。希氏束起搏是最生理的起搏方式,而且可纠正大部分的完全性左束支传导阻滞改善心脏再同步化,但也存在起搏阈值高、R波振幅低和潜在的希氏束远端病变风险。左束支呈扇形分布左室间隔内膜面下,起搏阈值、R波振幅同右室心尖部相似,而且左束支近端起搏可纠正病变于希氏束的左束支传导阻滞,可作为心脏再同步化治疗的备选方案。现就左束支的解剖、左束支区域起搏的电生理特点和左束支区域起搏的临床应用进行综述。
Abstract:
Compared with right ventricular apical pacing, the physiological pacing of His bundle pacing(HBP) and left bundle branch area pacing(LBBaP) significantly improved the electromechanical synchronization and cardiac function.HBP is the most physiological pacing,and can correct most of the complete left bundle branch block to improve cardiac resynchronization. Whereas, it has some shortages including high pacing threshold, low R-wave amplitude and potential risk of distal His bundle lesion. The pacing threshold and R wave amplitude of LBBaP are similar to that of the right ventricular apex pacing. Moreover, the LBBaP can correct the left bundle branch block, the lesion in His bundle, as an alternative to cardiac resynchronization. This article reviews the anatomy of the left bundle branch, the electrophysiological characteristics of LBBaP and the clinical application of LBBaP

参考文献/References:

[1] Wilkoff BL,Cook JR,Epstein AE,et al. Dual-chamber pacing or ventricular backup pacing in patients with an implantable defibrillator:the Dual Chamber and VVI Implantable Defibrillator (DAVID) Trial[J].?JAMA,2002,288(24):3115-3123.

[2] Lamas GA,Lee KL,Sweeney MO,et al. Ventricular pacing or dual-chamber pacing for sinus-node dysfunction[J].?N Engl J Med,2002,346(24):1854-1862.

[3] Sweeney MO,Hellkamp AS,Ellenbogen KA,et al. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction[J].Circulation,2003,107(23):2932-2937.

[4] Cleland JG,Daubert JC,Erdmann E,et al. The effect of cardiac resynchronization on morbidity and mortality in heart failure[J].?N Engl J Med, 2005,352(15):1539 -1549.

[5] Winnik S,Elsener C,Seifert B,et al. "Real world" experience in Cardiac Resynchronization Therapy at a Swiss Tertiary Care Center[ J].?Swiss Med Wkly, 2017,147:w14425.

[6] Sharma PS,Dandamudi G,Naperkowski A,et al. Permanent His-bundle pacing is feasible,safe,and superior to right ventricular pacing in routine clinical practice[J].?Heart Rhythm,2015,12(2):305-312.

[7] Sharma PS,Dandamudi G,Herweg B,et al. Permanent His-bundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy:a multicenter experience[J].?Heart Rhythm ,2018,15(3):413-420.

[8] Huang W,Su L,Wu S,et al. Long-term outcomes of His bundle pacing in patients with heart failure with left bundle branch block[J].?Heart,2019,105(2):137-143.

[9] Arnold AD,Shun-Shin MJ,Keene D,et al. His resynchronization versus biventricular pacing in patients?with?heart failure and left?bundle branch block[J].?J Am Coll Cardiol,2018,72(24):3112-3122.

[10] Lustgarten DL,Crespo EM,Arkhipova-Jenkins I,et al. His-bundle pacing versus biventricular pacing in cardiac resynchronization therapy patients:a crossover design comparison[J].?Heart Rhythm ,2015,12(7):1548-1557.

[11] Elizari MV. The normal variants in the left bundle branch system[J].?J Electrocardiol,2017,50(4):389-399.

[12] Huang W,Su L,Wu S,et al. A novel pacing strategy with low and stable output: pacing the left bundle branch immediately beyond the conduction block[J].?Can J Cardiol,2017,33(12):1736.e1-1736.e3.

[13] Massing GK,James TN. Anatomical configuration of the His bundle and bundle branches in the human heart[J].?Circulation,1976,53(4):609-621.

[14] James TN,Sherf L. Fine structure of the His bundle[J].?Circulation, 1971,44(1):9 -28.

[15] Narula OS. Longitudinal dissociation in the His bundle. Bundle branch block due to asynchronous conduction within the His bundle in man[J].?Circulation, 1977,56(6):996 -1006.

[16] Demoulin JC,Kulbertus HE. Histopathological examination of concept of left hemiblock[J].?Br Heart J,1972,34(8):807-814.

[17] Durrer D,van Dam RT,Freud GE,et al. Total excitation of the isolated human heart[J].?Circulation,1970,41(6):899-912.

[18] El-Sherif N,Amay-Y-Leon F,Schonfield C,et al. Normalization of bundle branch block patterns by distal His bundle pacing. Clinical and experimental evidence of longitudinal dissociation in the pathologic his bundle[J].?Circulation, 1978,57(3):473 -483.

[19] Sharma PS,Naperkowski A,Bauch TD,et al. Permanent His bundle pacing for cardiac resynchronization therapy in patients with heart failure and right bundle branch block[J].?Circ Arrhythm Electrophysiol,2018,11(9):e006613.

[20] Deshmukh A,Deshmukh P. His bundle pacing:initial experience and lessons learned[J].?J Electrocardiol,2016,49(5):658-663.

[21] Huang W,Chen X,Su L,et al. A beginner’s guide to permanent left bundle branch pacing[J].?Heart Rhythm,2019,16(12):1791-1796.

[22] Chen X,Wu S,Su L,et al. The characteristics of the electrocardiogram and the intracardiac electrogram in left bundle branch pacing[J].?J Cardiovasc Electrophysiol,2019,30(7):1096-1101.

[23] Zhang J,Wang Z,Cheng L,et al. Immediate clinical outcomes of left bundle branch area pacing vs conventional right ventricular pacing[J].?Clin Cardiol, 2019,42(8):768 -773.

[24] Chen K,Li Y,Dai Y,et al. Comparison of electrocardiogram characteristics and pacing parameters between left bundle branch pacing and right ventricular pacing in patients receiving pacemaker therapy[J].?Europace,2019,21(4):673-680.

[25] Zhang W,Huang J,Qi Y,et al. Cardiac resynchronization therapy by left bundle branch area pacing in patients with heart failure and left bundle branch block[J].?Heart Rhythm,2019,16(12):1783-1790.

[26] Upadhyay GA,Cherian T,Shatz DY,et al. Intracardiac delineation of septal conduction in left bundle-branch block patterns[J].?Circulation, 2019,139(16):1876 -1888.

[27] 范建华,钱剑峰.希氏束起搏研究进展[J]. 心血管病学进展,2018,39(4):547-551.

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更新日期/Last Update: 2020-08-11