在慢性心力衰竭与严重左心室功能障碍和慢性心房动的慢性心力衰竭中,导电系统节奏升级
Yasumasa Nohno1, Katsuhito Fujiu2, Ryosuke Kozu1
1Department of Cardiology, Saku Central Hospital Advanced Care Center.
International heart journal
|July 17, 2023
概括
心脏再同步疗法 (CRT) 是心力衰竭的治疗方法,但有些患者没有反应. 导电系统步调 (CSP) 提供了一个替代方案,通过使用His-bundle步调 (HBP) 或左捆分支区域步调 (LBBAP) 来提高CRT的有效性.
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:
- 心脏再同步疗法 (CRT) 是严重充血性心力衰竭的标准治疗方法.
- 大约三分之一接受CRT的患者对治疗没有反应.
- 传导系统步调 (CSP),包括His-bundle步调 (HBP) 和左捆分支区域步调 (LBBAP),已成为CRT的一个有希望的替代方案和辅助.
研究的目的:
- 描述一种用于将患者升级到用CSP进行CRT的新方法.
- 展示一系列案例,证明在CRT升级过程中使用心房口用于HBP和LBBAP的可行性.
- 评估这种结合CRT和CSP战略的有效性和简单性.
主要方法:
- 两例末期心力衰竭患者的病例被升级为用CSP进行CRT.
- 植入HBP和LBBAP导线并连接到可植入心脏除器/CRT除器的心房口.
- 该程序涉及使用现有的心房口用于新型节拍线索.
主要成果:
- 在这两种情况下,HBP和LBBAP导入心房口的植入在技术上都是成功的.
- 升级的CRT与CSP疗法被认为是一种简单,合理和有效的治疗方法.
- 这种方法解决了结合CRT和CSP系统中的连接挑战.
结论:
- 通过使用心房端口用于HBP和LBBAP导线升级到用CSP进行CRT是一种可行的策略.
- 这种方法为患有严重心力衰竭的患者提供了简单而有效的解决方案.
- 与单独CRT相比,CSP与CRT相结合可能会提高治疗疗效.
相关概念视频
01:19Conduction System of the Heart
9.1K
Autorhythmicity is a term that refers to the heart's inherent ability to generate electrical signals and instigate muscle contractions. This self-regulating conduction system within the heart consists of two key components: the pacemaker cells and specialized conducting cells.
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
9.1K
01:29Heart Failure II: Pathophysiology
16
Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
16
01:25Dysrhythmias VI: Management of Dysrhythmias
19
Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
19
01:22Heart Failure VI: Adjunct Therapies
16
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
16
01:30Cardiomyopathy II: Dilated Cardiomyopathy
11
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
11
01:28Disturbances in Heart Rhythm
1.0K
Arrhythmia or dysrhythmia refers to an abnormal heart rhythm caused by a defect in the heart's conduction system. It can cause the heart to beat irregularly, too quickly, or too slowly, leading to symptoms like chest pain, shortness of breath, and fainting. Factors such as stress, caffeine, alcohol, nicotine, cocaine, certain drugs, congenital defects, diseases, and electrolyte abnormalities can trigger arrhythmias.
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
Arrhythmias are categorized by their speed, rhythm, and origin. A slow...
1.0K