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无左心室内心内和左束区域节奏对双心室再极化指标的影响

Nadeev Wijesuriya¹, Marina Strocchi², Mark Elliott²

¹King's College London, London, United Kingdom; Guy's and St Thomas's NHS Foundation Trust, London, United Kingdom.

|May 28, 2025

概括

无心脏再同步疗法 (CRT) 使用内心节奏或左捆分支区域节奏 (LBBAP) 改善了心室再极化. 与双心室节奏相比,LV-only节奏表现出更好的结果.

科学领域:

心脏病学心脏病学
电子生理学电子生理学
医疗成像医学成像

背景情况:

心脏再同步疗法 (CRT) 带上心节奏可以增加心律失常的风险,由于对心室复极化的不良影响.
无LV内心CRT,包括无左束分支区域节奏 (LBBAP),可以通过促进生理性跨壁激活来降低这种风险.

研究的目的:

评估无LV内心节奏和无LBBAP对使用心电成像 (ECGi) 的复极化指标的影响.

主要方法:

十名无内心CRT系统的患者接受了ECGI研究,使用各种节奏设置 (RV,LV,BiVP,AV优化LV).
分析了心上电图,以获得复极化和激活-恢复间隔分散度量.
主要结局是从基线再极化指标的急性减少.

主要成果:

最佳无节奏显著改善了双心室复极化分散23.7% (P < .01),LBBAP显示出比侧壁节奏 (18%) 更明显的效果 (29.3%).
对于激活-恢复间隔分散和再极化梯度,也发现了类似的改善.
只有LV的节奏 (LBBAP或AV优化的LV) 比双心脏节奏 (BiVP) 取得了更大的改善.

结论:

优化的无LV内心节奏和LBBAP增强了ECGi衍生的心室再极化.
只有LV的节奏似乎优于内心BiVP,可能是因为避免了来自碰撞节奏波线的复极化异质性.

关键词:

心脏再同步治疗心脏再同步治疗导电系统节奏调节导电系统节奏调节电心图像成像电心图像成像没有的无.再极化是指重新极化.

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