Takemoto Masao, Nakashima Atsuhiro, Muneuchi Jun, Yamamura Ken-Ichiro, Shiokawa Yuichi, Sunagawa Kenji, Tominaga Ryuji
Department of Cardiovascular Medicine, Heart Center, Kyushu University Hospital, 3-1-1Maidashi, Higashi-ku, Fukuoka 812-8582, Japan.
Pacing Clin Electrophysiol. 2010 Jan;33(1):e4-7. doi: 10.1111/j.1540-8159.2009.02559.x. Epub 2009 Sep 30.
We report a pediatric patient with a congenitally corrected transposition of the great arteries (ccTGA)(SLL) in which permanent para-Hisian pacing (PPHP) could improve dyssynchrony-associated systemic ventricular (SV) dysfunction resulting from permanent morphologic left ventricular pacing for complete atrioventricular block. Since, in patients with ccTGA(SLL), an elongated His-bundle runs medially toward the upper septum to the site of the fibrous continuity between the right-sided mitral valve and pulmonary artery, the His-bundle may easily be captured by a pacing lead, unlike in normal hearts. Thus, PPHP may be an effective therapeutic strategy for the treatment of dyssynchrony-associated SV dysfunction associated with ccTGA (SLL).
我们报告了一名患有先天性矫正型大动脉转位（ccTGA）（SLL型）的儿科患者，对于该患者，因完全性房室传导阻滞而进行的永久性形态学左心室起搏导致的与不同步相关的系统性心室（SV）功能障碍，永久性希氏束旁起搏（PPHP）可予以改善。由于在ccTGA（SLL）患者中，细长的希氏束向内侧延伸至上间隔，到达右侧二尖瓣与肺动脉之间纤维连续的部位，与正常心脏不同，起搏导线可能很容易捕获希氏束。因此，PPHP可能是治疗与ccTGA（SLL）相关的不同步性SV功能障碍的有效治疗策略。
