[1]岳岸娜 钱步云 陈璐 孙康云 邹建刚.左束支起搏成功夺获左束支的标准[J].心血管病学进展,2024,(4):289.[doi:10.16806/j.cnki.issn.1004-3934.2024.04.001]
　YUE Anna,QIAN Buyun,CHEN Lu,et al.Criteria for successful capture of the left bundle branch during left bundle branch pacing[J].Advances in Cardiovascular Diseases,2024,(4):289.[doi:10.16806/j.cnki.issn.1004-3934.2024.04.001]
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左束支起搏成功夺获左束支的标准()
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《心血管病学进展》[ISSN:51-1187/R/CN:1004-3934]

卷:
期数:
2024年4期
页码:
289
栏目:
综述
出版日期:
2024-04-25

文章信息/Info

Title:
Criteria for successful capture of the left bundle branch during left bundle branch pacing
作者:
岳岸娜1 钱步云1 陈璐1 孙康云1 邹建刚2
（1.南京医科大学附属苏州医院心血管内科,江苏 苏州 215008；2.南京医科大学第一附属医院心血管内科,江苏 南京 210029）
Author(s):
YUE Anna1; QIAN Buyun1; CHEN Lu1; SUN Kangyun1; Zou Jiangang2
（1.Department of Cardiology,Suzhou Municipal Hospital Affiliated to Nanjing Medical University,Suzhou 215000,Jiangsu,China；2.Department of Cardiology,the First Affiliated Hospital of Nanjing Medical University,Nanjing 210029,Jiangsu,China）
关键词:
左束支起搏; 左束支夺获标准; 左束支电位; 损伤电流; 左心室激动时间
Keywords:
Left bundle branch pacing;  Criteria for capture of left bundle branch;  Left bundle branch potential;  Current of injury;  Left ventricular activation time
DOI:
10.16806/j.cnki.issn.1004-3934.2024.04.001
摘要:
左束支起搏定义为起搏夺获左束支，包括左束支主干及其分支，伴或不伴周围心肌夺获，且夺获阈值一般不超过1.5V/0.4ms。记录到逆行希氏束电位或顺行左束支电位是左束支夺获的直接证据，但该操作较为复杂，临床使用较少。在起搏导线植入过程中，通常根据心电图变化及影像学表现来判断导线是否成功夺获左束支。具体包括体表心电图QRS波形态和时限变化，左室达峰时间变化，腔内心电图检测到左束支电位或损伤电流，以及改变起搏输出时观察到非选择性左束支起搏转换到选择性左束支起搏或左室间隔部起搏等。由于患者存在个体差异，一些学者提出了个性化的左室达峰时间，V6-V1峰值间期以及LBBP评分等方法进一步补充了夺获标准。本综述旨在分析行左束支起搏手术过程中调试导线电极位置的依据，归纳总结成功夺获左束支的标准。
Abstract:
Left bundle branch pacing is defined as the capture of the left bundle branch by pacing, including the left bundle branch trunk and its branches, with or without peripheral myocardial capture, and the capture threshold generally does not exceed 1.5V/0.4ms. The recording of retrograde His bundle potential or anterograde left bundle branch potential is the direct evidence of left bundle branch capture, but the operation is more complex and less used in clinical practice. During pacemaker lead implantation, ECG changes and imaging findings are usually used to determine whether the lead successfully captured the left bundle branch. Specifically, it includes changes in the shape and duration of QRS wave in body surface ECG, changes in left ventricular activation time, detection of left bundle branch potential or injury current in intracavitary ECG, and observation of non-selective left bundle branch pacing switching to selective left bundle branch pacing or left ventricular septal pacing when pacing output is changed. Due to individual differences in patients, some scholars have proposed personalized methods such as left ventricular peak time, V6-V1 peak interval, and LBBP score to further supplement the capture criteria.This review aims to analyze the basis of adjusting the lead electrode position during the left bundle branch pacing operation, and summarize the criteria for successful capture of the left bundle branch.

参考文献/References:

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更新日期/Last Update: 2024-05-31