在他的优化心脏再同步治疗中,心房延迟优化:一个案例报告
Minh Nguyen Quang1, Dung Kieu Ngoc1, Son Nguyen Khac Le1
1Arrhythmology Department Cho Ray Hospital Ho Chi Minh City Vietnam.
Clinical case reports
|January 21, 2026
概括
他的捆绑节奏 (HBP) 与优化心房 (AV) 延迟,称为他的优化CRT (HOT-CRT),在心力衰竭患者中改善了血液动力学功能和QRS持续时间. 这种方法提高了那些对传统CRT无反应的人的结果.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 医疗器械 医疗器械
背景情况:
- 他的捆绑节奏 (HBP) 是一种生理节奏策略,可以保持心室同步.
- 优化心房 (AV) 延迟对于传导系统节奏的血液动力效率至关重要.
- 常规的心脏再同步治疗 (CRT) 在一些心力衰竭患者中可能是不理想的.
研究的目的:
- 报告一个患有扩张性心肌病和严重心力衰竭的患者的His-optimized CRT (HOT-CRT) 病例.
- 为了证明AV延迟优化对血液动力学功能和QRS持续时间的影响.
- 突出 HOT-CRT 对传统 CRT 反应不良患者的潜在好处.
主要方法:
- 一名患有严重心力衰竭和不响应的双心室节奏的患者接受了His bundle lead重新定位.
- 他的捆绑节奏 (HBP) 与他的优化CRT (HOT-CRT) 结合在一起.
- 术后进行了心房 (AV) 延迟优化.
主要成果:
- 在HOT-CRT和AV延迟优化之后,QRS持续时间从185ms缩小到120ms.
- 患者在15个月的随访后表现出改善的血液动力学功能和临床稳定性.
- 排气分数从16%提高到25%,没有复发的心室动脉冲动.
结论:
- 与AV延迟优化相结合的HOT-CRT为心力衰竭患者提供了有价值的替代方案,这些患者对传统的CRT反应不佳.
- 个性化AV延迟调整对于最大限度地提高导电系统节奏的治疗结果至关重要.
- 关注QRS形态和持续时间有助于识别适合个性化AV编程的候选人.
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