在左分支块模式中内心导通线的划线
Gaurav A Upadhyay1, Tharian Cherian1, Dalise Y Shatz1
1The University of Chicago Medicine, Center for Arrhythmia Care, Pritzker School of Medicine, Department of Medicine, Section of Cardiology, IL.
Circulation
|February 2, 2019
概括
这项研究表明,左束支部的完整导电阻塞在左束支部阻塞 (LBBB) 模式的患者中很常见. 他的捆绑节奏有效地纠正了QRS持续时间,
科学领域:
- 心脏病学
- 电生理学
- 心脏传导系统
背景情况:
- 之前还没有详细研究左分支阻塞 (LBBB) 患者的 Septal 激活模式.
- 了解His-Purkinje系统中的传导块对于管理LBBB至关重要.
研究的目的:
- 在LBBB患者的左捆分支中调查完整导电阻 (CCB) 的存在和位置.
- 评估His捆绑步调在这些患者中纠正宽QRS的有效性.
主要方法:
- 在85名LBBB模式和对照患者中使用多电极导管进行心内映射.
- 分析QRS宽度,His持续时间,His-心室间隔和隔膜导电模式.
- 在有或没有CCB的患者中对His捆绑节奏反应的评估.
主要成果:
- 在64%的LBBB患者中发现了完整的导电阻塞 (CCB),通常位于左侧内或近端左侧分支.
- 在54%的LBBB患者中,他的捆绑节奏纠正了广泛的QRS,在CCB患者中,成功率更高 (85%).
- 内心CCB检测显示出比表面心电图更高的预测值.
结论:
- 在LBBB中 Septal传导异质,CCB经常在左侧的His纤维中观察到.
- 通过隐藏的普尔金耶纤维招募.
- 与表面心电图标准相比,心内图谱可以改善患者选择再同步治疗.
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