後上部束(PSB)ペーシング:心房内同期ペーシングの実現可能性、メカニズム、および中期転帰
Zhaohui Qiu1, Wu Xianhao1, Wei Hu1
1Department of Cardiology, Shanghai Tong Ren Hospital, Shanghai Jiao Tong University School of Medicine. (Z.Q., X.W., W.H., Z.X., Z.O., Y.Z.).
Circulation. Arrhythmia and electrophysiology
|December 25, 2025
まとめ
後上部束(PSB)ペーシングは、安全で効果的な心房ペーシング法です。この手技は心房間の電気的同期を維持し、伝導遅延のある患者に有望です。
科学分野:
- 循環器内科; 電気生理学; 医療機器
背景:
- 従来の右心房心耳ペーシングは心房内同期を妨げる可能性があります。後上部束(PSB)ペーシングは、上大静脈内の心房間筋接続を標的とします。PSBペーシングは、心房ペーシングにおいて解剖学的な利点を提供する可能性があります。
研究 の 目的:
- PSBペーシングの実現可能性を検証すること。PSBペーシングの中期臨床転帰を評価すること。PSBペーシングが心房内同期に与える影響を評価すること。
主な方法:
- PSBペーシングを受けた33人の患者の後ろ向きコホート分析。上大静脈の内壁へのリード留置。手技前後の電気生理学的および心エコー検査パラメータの評価。
主要な成果:
- 手技的成功率100%、リードパラメータは安定し、合併症は認められませんでした。特に伝導遅延のある患者では、P波期間が有意に短縮しました。心エコー検査パラメータは維持され、臨床イベントは最小限でした。
結論:
- PSBペーシングは、実現可能で安全かつ効果的な心房ペーシング戦略です。心房内の電気的同期を維持し、機能的な利点を提供します。PSBペーシングは、生理的な心房ペーシングの有望な代替法です。
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