Department of Electrocardiology, Medical University of Łódź, Poland.
Cardiol J. 2010;17(1):35-41.
It has been reported that bifocal pacing (BiF) in the right ventricle might be an alternative to unsuccessful left ventricular lead implantation. This case report presents an assessment of the clinical and hemodynamic parameters during a three month follow-up in patients implanted with right ventricular BiF.
Eight patients who underwent unsuccessful left ventricular lead implantation were implanted with a bifocal system in the right ventricular. Leads were implanted in the right atrium appendage, the apex and the right ventricular outflow tract and connected to the cardiac resynchronization therapy pacemaker. All patients performed a sixminute walking test and underwent echocardiography after the implantation and after the three month follow-up.
We found a significant performance increase in the six minute walking test and reduction in New York Heart Association class and mitral regurgitation in echocardiography study, as well as a significant increase in left ventricular ejection fraction, and cardiac output directly after the implantation, as well as at threemonth follow-up in patients after BiF implantation.
Right ventricular bifocal pacing in patients with cardiac resynchronization therapy indication and unsuccessful left ventricular lead placement seems to be a beneficial treatment for heart failure. Satisfactory hemodynamic and clinical results were observed directly after BiF implantation and during the three month follow-up.
据报道，右心室双腔起搏（BiF）可能是左心室起搏植入失败的替代方法。本病例报告介绍了对植入右心室 BiF 的患者进行三个月随访期间的临床和血流动力学参数评估。
8 例左心室起搏植入失败的患者在右心室植入双腔系统。导线植入右心房心耳、心尖和右心室流出道，并连接到心脏再同步治疗起搏器。所有患者在植入后和三个月随访后均进行 6 分钟步行测试和超声心动图检查。
我们发现 6 分钟步行测试表现明显提高，纽约心脏协会心功能分级和超声心动图检查中的二尖瓣反流减少，以及左心室射血分数、心输出量直接在植入后，以及在 BiF 植入后三个月随访时均有显著增加。
对于有心脏再同步治疗指征和左心室起搏植入失败的患者，右心室双腔起搏似乎是心力衰竭的有益治疗方法。直接在 BiF 植入后和三个月随访期间观察到满意的血流动力学和临床结果。
