Bailin Steven J
Iowa Heart Center, Director of Electrophysiology, Iowa Heart Hospital at Mercy, Des Moines 50314, USA.
Card Electrophysiol Rev. 2003 Dec;7(4):325-8. doi: 10.1023/B:CEPR.0000023131.13609.ab.
The site of atrial pacing influences atrial activation patterns. It is believed that disparities in atrial activation and repolarization are contributors to the development and recurrence of atrial arrhythmias. We hypothesized that pacing from Bachmann's Bundle would improve clinical outcomes in patients with paroxysmal atrial fibrillation compared to right atrial appendage pacing. Pacing from Bachmann's Bundle results in a significant reduction in P wave duration and improvement in biatrial activation symmetry compared to right atrial appendage pacing. Compared to right atrial appendage pacing, Bachmann's bundle pacing improves sinus rhythm (75% vs. 47% at two years, p < 0.01) in patients with a history of paroxysmal atrial fibrillation. Recent studies have confirmed the benefits of Bachmann's Bundle pacing on atrial activation and rhythm regulation. Thus, Bachman's Bundle should be considered the preferred site for atrial pacing in patients with a history of paroxysmal atrial fibrillation.
心房起搏部位会影响心房激动模式。据信，心房激动和复极的差异是导致房性心律失常发生和复发的因素。我们假设，与右心耳起搏相比，从巴赫曼束起搏可改善阵发性心房颤动患者的临床结局。与右心耳起搏相比，从巴赫曼束起搏可使P波时限显著缩短，并改善双房激动对称性。与右心耳起搏相比，巴赫曼束起搏可改善有阵发性心房颤动病史患者的窦性心律（两年时为75%对47%，p<0.01）。近期研究已证实巴赫曼束起搏在心房激动和节律调控方面的益处。因此，对于有阵发性心房颤动病史的患者，应将巴赫曼束视为心房起搏的首选部位。
