电生理学特征和右心室激活的临床相关性在左捆分支区域节奏 (RV-LBBAP研究) 期间
Shunmuga Sundaram Ponnusamy1, Vithiya Ganesan2, Vadivelu Ramalingam1
1Department of Cardiology, Velammal Medical College, Madurai, India.
Heart rhythm
|November 4, 2024
概括
左捆分支区域节奏 (LBBAP) 主要导致右捆分支 (RBB) 延迟. 这项研究澄清了LBBAP期间的RV激活模式,确定了RBB介导的激活在选择性节奏与完整的HB激活中是常见的.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心脏节拍是因为心脏节拍.
背景情况:
- 众所周知,由于左束预激发,左束分支区域节奏 (LBBAP) 会导致右束分支 (RBB) 延迟模式.
- 在LBBAP期间右心室 (RV) 激活的精确机制在很大程度上仍未被描述.
研究的目的:
- 为了研究LBBAP期间RV激活的电生理学特征.
- 在LBBAP期间映射RBB,并将发现与临床参数相关联.
主要方法:
- 连续接受成功LBBAP的患者的分析.
- 排除患有RBB阻断,RV节奏节奏或低于最佳电图的患者.
- 在LBBAP期间连续记录他的束 (HB) 和RBB电图.
- 将RV激活分为三种类型:I型 (RBB介导),II型 (横 septal) 和III型 (融合).
主要成果:
- 包括86名患者;94%接受了左束枝节拍 (LBBP).
- 在正常QRS患者中,选择性LBBP (S-LBBP) 主要显示I型激活 (87%).
- 在正常QRS患者中,非选择性LBBP (NS-LBBP) 通常显示III型激活 (91%).
- 在S-LBBP和NS-LBBP期间,左捆分支阻塞的患者中,III型激活普遍存在.
- I型激活只发生在S-LBBP期间逆行HB激活时.
- 左心室隔膜节奏导致II型激活.
- 没有逆行性HB激活的患者有更大的LV终端-透缩直径,更低的LVEF和延长的HV间隔.
结论:
- 生理学RBB介导 (I型) RV激活是S-LBBP期间在完整的逆向HB激活患者中占主导模式.
- 在NS-LBBP期间的Type III模式是由多个激活波线的融合产生的.
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