由导体外部化导致的不可逆转的左心室电故障,通过左束分支区域节奏来管理:一个案例报告
Jaber Almohammad1, Ahmed Almarzuqi1, Habib Rehman Khan1
1London Health Sciences Centre Research Institute, Western University, 339 Windermere Road, London, ON N6A 5A5, Canada.
European heart journal. Case reports
|February 23, 2026
概括
导体外部化导致左心室失效. 当冠状动脉-鼻腔重植入不可能时,左束支部区域节奏 (LBBAP) 提供了一个成功的生理替代方案.
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:
- 由于导体外部化而导致的透静脉故障是一个已知的问题.
- 需要提取的左心室 (LV) 冠状 sinus (CS) 衰竭并不常见.
- 导电系统节奏,特别是左束支部区域节奏 (LBBAP),在CS重植入无法实现时,为患者提供了一个生理替代方案.
研究的目的:
- 报告由于导体外部化而导致LV CS电线持续发生电故障的情况.
- 突出在特定患者解剖学中CS再植入的挑战.
- 在这种情况下,证明LBBAP作为救援疗法的有效性.
主要方法:
- 一名67岁的男性患有非缺血性心肌病,经历了LV衰竭.
- 提取揭示了导体外部化;CS重新植入被解剖学排除.
- 左捆分支区域节奏 (LBBAP) 已成功地植入作为替代方案.
主要成果:
- 爆破的LV显示导体外部化.
- 重新植入冠状动脉鼻是不可能的.
- 植入LBBAP导致了较低的捕获值和稳定的传感.
- 在LBBAP后, LV喷射率从10-15%提高到20-25%.
- 患者的病情改善至NYHA I级,血液动力学稳定.
结论:
- 由于导体外部化,LV CS电线中可能会出现持续的电故障.
- 当CS再植入无法实现时,LBBAP是一种可行的生理节奏选择.
- 这一案例强调了考虑传导系统步调对于CRT优化的重要性.
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