Trohman Richard G, Kim Michael H, Pinski Sergio L
Department of Medicine, Section of Cardiology, Electrophysiology, Arrhythmia, and Pacemaker Service, Rush-Presbyterian-St Luke's Medical Centre and Rush Medical College, Chicago, IL 60612, USA.
Lancet. 2004;364(9446):1701-19. doi: 10.1016/S0140-6736(04)17358-3.
Permanent cardiac pacing remains the only effective treatment for chronic, symptomatic bradycardia. In recent years, the role of implantable pacing devices has expanded substantially. At the beginning of the 21st century, exciting developments in technology seem to happen at an exponential rate. Major advances have extended the use of pacing beyond the arrhythmia horizon. Such developments include dual-chamber pacers, rate-response algorithms, improved functionality of implantable cardioverter defibrillators, combinations of sensors for optimum physiological response, and advances in lead placement and extraction. Cardiac pacing is poised to help millions of patients worldwide to live better electrically. We review pacing studies of sick-sinus syndrome, neurocardiogenic syncope, hypertrophic obstructive cardiomyopathy, and cardiac resynchronisation therapy, which are common or controversial indications for cardiac pacing. We also look at the benefits and complications of implantation in specific arrhythmias, suitability of different pacing modes, and the role of permanent pacing in the management of patients with heart failure.
永久性心脏起搏仍然是慢性症状性心动过缓的唯一有效治疗方法。近年来，植入式起搏装置的作用已大幅扩展。在21世纪初，技术上令人兴奋的发展似乎以指数级速度发生。重大进展已将起搏的应用范围扩展到心律失常领域之外。这些发展包括双腔起搏器、频率应答算法、植入式心脏复律除颤器功能的改善、用于优化生理反应的传感器组合以及导线植入和拔除技术的进步。心脏起搏有望帮助全球数百万患者在电生理方面生活得更好。我们回顾了病态窦房结综合征、神经心源性晕厥、肥厚性梗阻性心肌病和心脏再同步治疗的起搏研究，这些是心脏起搏常见或有争议的适应证。我们还探讨了特定心律失常植入的益处和并发症、不同起搏模式的适用性以及永久性起搏在心力衰竭患者管理中的作用。
