永久的,直接的His-bundle节奏:在正常的His-Purkinje激活患者中,一种新的心脏节奏方法
P Deshmukh1, D A Casavant, M Romanyshyn
1Cardiology Division, Robert Packer Hospital, Sayre, Penn, and Medtronic, Inc, Minneapolis, MN, USA.
Circulation
|March 1, 2000
概括
永久的His-bundle节奏 (DHBP) 在某些患有慢性心房动和扩张性心肌病的患者中是可行的. 这种创新的节奏方法改善了心脏功能,并减少了心室尺寸,为传统节奏技术提供了一个有前途的替代方案.
科学领域:
- 心脏病学 心脏病学
- 电力生理学 电力生理学
- 医疗器械 医疗器械
背景情况:
- 与尖端节奏相比,直接的His-bundle节奏 (DHBP) 提供同步的腹腔脱极化和改善心脏功能.
- 以前对人类永久性DHBP的尝试没有成功,限制了其临床应用.
研究的目的:
- 评估慢性心房动和扩张性心肌病症患者永久直接His捆节奏 (DHBP) 的可行性和结果.
主要方法:
- 使用电生理学导管选了18名患有慢性心房动和扩张性心肌病症的患者,以寻找永久的DHBP.
- 在14名患者中有12名患者成功实现了永久的DHBP,可靠的His捆绑刺激.
- 在患有快速心室反应和植入单腔速率响应心脏起器的患者中进行射频移除.
主要成果:
- 永久的DHBP在12名患者中成功植入,显示了2.4+/-1.0V的急性节奏值.
- 观察到心脏功能的显著改善,包括左心室尺寸减少和射出分数增加.
- 两名患者在8个月和36个月死亡,与节奏程序无关.
结论:
- 永久性DHBP是一种可行和有效的节奏策略,可用于选择患有慢性心房动和扩大心肌病的患者.
- 高血压导致左心室尺寸显著减少,并增强整体心脏功能.
- 这种技术代表了心脏节奏的潜在进步,提供了更好的血液动力学益处.
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