带有或没有阳极捕获的左束枝节奏:对心室激活模式和急性血液动力学的影响
Nadine Ali1, Khulat Saqi1, Ahran D Arnold1
1National Heart and Lung Institute-Cardiovascular Science, The Hammersmith Hospital, Imperial College London, B-Block South, 2nd Floor, Du Cane Road, London W12 0NN, UK.
概括
在左捆分支节奏 (LBBP) 期间的阳捕获通过刺激RV隔膜来推进右心室 (RV) 激活. 然而,这种方法需要更高的能量输出,但没有提供显著的血液动力学益处.
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:
- 左捆枝节奏 (LBBP) 提供了生理左心室激活.
- LBBP可能导致右心室 (RV) 激活延迟.
- 阳极捕获是一种在LBBP期间潜在地推进RV激活的技术.
研究的目的:
- 为了研究在LBBP期间使用阳极捕获进行高级RV激活的机制.
- 为了确定阴道捕获是否提供血液动力学益处.
- 评估在LBBP中寻求阳道捕获的临床必要性.
主要方法:
- 招募了21名患有LBBP的患者,这些患者的线索表现出阳捕获.
- 使用心电图和非侵入性绘图研究了心室激活模式和时间.
- 测量了在LBBP期间的急性血液动力学反应,有或没有阳极捕获.
主要成果:
- 通过刺激RV隔膜心肌,而不是右束,通过阳道捕获先进的RV激活.
- QRS持续时间和总心室激活时间在阳捕获时显著缩短.
- 阳极捕获需要更高的节奏输出,而急性血液动力学没有显著改善.
结论:
- 在LBBP期间的阳极捕获通过RV隔膜肌心脏刺激推进RV激活.
- 这种技术需要更高的能量输出.
- 阳道捕获不会改善急性血液动力学性能,这表明它可能不是LBBP的必要目标.
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