水平轴在无心脏起器植入部位的影响节奏QRS持续时间超过垂直轴
Hirotsugu Sato1, Yuichi Hori1,2, Yuta Kimura1
1Department of Cardiology, Dokkyo Medical University Saitama Medical Center, Saitama, Japan.
Pacing and clinical electrophysiology : PACE
|December 22, 2025
概括
在RV隔膜中植入无心脏起器:水平位置与节奏QRS持续时间相关,而不是垂直. 原生QRS持续时间也会影响节奏QRS,但需要对节奏诱导心肌病风险进行进一步研究.
科学领域:
- 心脏病学 心脏病学
- 医疗器械 医疗器械
- 电子生理学 电子生理学
背景情况:
- 在顶隔膜中植入无心脏起器 (LP) 与节奏诱导心肌病 (PICM) 有关.
- 精确的LP定位在右心室 (RV) 隔膜内对于最佳结果至关重要.
- 了解植入部位对心脏功能的影响至关重要.
研究的目的:
- 在RV隔膜内确定无心脏起器的最佳植入部位.
- 调查LP植入位置和节奏诱导的QRS持续时间 (p-QRS持续时间) 之间的关系.
- 评估植入部位和节奏诱导心肌病 (PICM) 之间的关联.
主要方法:
- 54名患者通过3D旋转血管学 (3D-RA) 引导进行了无心脏起器植入.
- 植入点使用水平和垂直轴精确地绘制了地图.
- 节奏QRS持续时间 (p-QRS持续时间) 在手术期间测量,心声学评估了12个月后的PICM进展.
主要成果:
- 所有54个LP都成功地植入隔膜.
- 水平植入位置与p-QRS持续时间 (R=0.59) 有显著的相关性.
- 原生QRS持续时间是延长p-QRS持续时间的独立预测因素,但没有观察到PICM进展.
结论:
- 水平的RV隔膜位置是p-QRS持续时间的更强的预测因素,而不是在无心脏起器植入期间的垂直位置.
- 延长的本源QRS持续时间独立预测了延长的p-QRS持续时间.
- 需要进一步的研究,以充分阐明植入部位和PICM发展之间的联系.
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