LBBP—慢性心力衰竭再同步化治疗的优选?

    Optimal choice of cardiac resynchronization therapy for chronic heart failure — left bundle branch pacing

    • 摘要: 慢性心力衰竭(chronic heart failure,CHF)作为常见的心血管疾病,多存在心脏电-机械失同步。心脏再同步治疗(cardiac resynchronization therapy, CRT)是一种有效治疗伴有心室不同步的难治性CHF的方式。传统的双心室起搏(biventricular pacing,BVP)CRT能够纠正CHF患者的电-机械失同步,逆转心脏重构,改善临床症状的同时明显降低患者再住院率及死亡率。但是其并非真正意义上的生理性同步起搏,且有将近30%的患者不能从中获益。近来以希氏束起搏(His bundle pacing, HBP)和左束支起搏(left bundle branch pacing, LBBP)为代表的希-浦系统起搏作为生理性起搏在CHF再同步化治疗中得到了肯定。尤其是LBBP,在达到更窄的QRS波的同时、具有更低的阈值和更稳定的输出。本文概述LBBP在CHF防治中的应用现状及前景。

       

      Abstract: As a common cardiovascular disease, chronic heart failure is mainly caused by cardiac electromechanical dyssynchrony. Cardiac resynchronization therapy (CRT) is an effective treatment of intractable chronic heart failure with ventricular asynchronous manner. Traditional biventricular pacing can correct electro-mechanical dissynchronization, reverse cardiac remodeling, improve clinical symptoms and significantly reduce the re-hosptialization rate and mortality in patients with chronic heart failure. However, it is not a true physiologic synchronous pacing and nearly 30% of patients fail to benefit from it. In recent years, His bundle pacing (HBP) and left bundle branch pacing (LBBP), as the representative of physiologic pacing, have shown great effect in CRT. LBBP, in particular, is not only effective for chronic heart failure but also can achieve narrower QRS wave, lower threshold and more stable output. This paper reviews the application status and prospect of LBBP in the prevention and treatment of chronic heart failure.

       

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