使用光量较少的进行左束枝节奏的右侧方法:技术考虑和后续结果
Shunmuga Sundaram Ponnusamy1, Vithiya Ganesan2, Vadivelu Ramalingam1
1Department of Cardiology, Velammal Medical College, Madurai, India.
Journal of cardiovascular electrophysiology
|November 14, 2023
概括
右侧左束枝节拍 (LBBP) 是需要心脏节拍的患者的可行和有效的替代方案,特别是当左下关节静脉方法是不可能的. 这种方法在需要心脏再同步治疗 (CRT) 的患者中有望改善心脏功能.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 左束枝节拍 (LBBP) 是一种新兴的心脏节拍技术,通常通过左下关节静脉进行访问.
- 诸如静脉阻塞或持续的左上 vena cava (PLSVC) 等挑战可能需要替代方法.
研究的目的:
- 为了评估LBBP的可行性,有效性和长期结果,使用通过右下关节静脉植入的没有光线的.
- 在患有特定解剖学挑战的患者中评估右侧方法的安全性和有效性.
主要方法:
- 一个回顾性,单中心的观察性研究,连续接受LBBP的患者用3830个SelectSecureTM领先.
- 当左侧通道不可行时,使用右下关节静脉通道,收集有关程序成功,患者特征和结果的数据.
主要成果:
- 右侧方法在84%的尝试病例 (16/19名患者) 中成功,通常是由于PLSVC或左静脉阻塞.
- LBBP导致QRS持续时间和左心室喷射率 (LVEF) 的显著改善,特别是在接受心脏再同步治疗 (CRT) 的患者中.
- 虽然有效,但与左侧方法相比,右侧方法与更高的平均光镜持续时间和辐射剂量有关.
结论:
- 右侧LBBP是一种可行的,安全和有效的策略,用于患者需要节奏为症状勃节律失常和CRT.
- 建议进一步开发用于右侧方法的专用工具,以减轻增加的光镜时间和辐射暴露.
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