左心室外流管阻塞后的左捆分支区域节奏:一个案例报告
Xiaoming Lian1, Xiao-Min Yang1, Rui Zhang1
1Department of Cardiology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, #1665 Kong Jiang Road, Shanghai 200092, China.
European heart journal. Case reports
|January 26, 2026
概括
左束支部区域节奏 (LBBAP) 可以诱导左心室外流通道 (LVOT) 阻塞在高性心肌病 (HCM) 患者. 调整节奏设置,比如从双极变化为单极变化,可以解决这种障碍并改善症状.
科学领域:
- 心脏病学 心脏病学
- 电子生理学 电子生理学
- 心血管成像 - 心血管成像
背景情况:
- 左捆支部区域节奏 (LBBAP) 是非阻塞性多变性心肌病 (HCM) 的安全节奏策略.
- 在易患病的患者中,LBBAP对左心室外流通道 (LVOT) 阻塞的影响尚不清楚.
研究的目的:
- 研究LBBAP配置和LVOT阻塞之间的关系.
- 突出特定患者群体中节奏诱导的LVOT阻塞的潜力.
主要方法:
- 一个病例报告是一名76岁的女性,患有心室节功能障碍,接受LBBAP.
- 声心图用于评估LVOT梯度和全球纵向应变.
- 与双极低压和单极高压节奏的LVOT梯度的比较.
主要成果:
- 在患者身上,LBBAP诱导了显著的LVOT阻塞 (112.6 mmHg梯度).
- 单极高压节奏降低了LVOT梯度到15 mmHg,缓解了症状.
- 全球纵向应变随着调整的节奏配置而得到改善.
结论:
- 节奏配置可以与LVOT动态相互作用,可能诱导阻塞.
- 临床医生必须识别和管理节奏诱导的LVOT阻塞,特别是患有隔膜缩或 mitrales异常的患者.
- 对节奏参数的个性化编程对于优化LBBAP患者的结果至关重要.
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