永久性希氏束起搏：追求生理性心室起搏。
Permanent His-bundle pacing: seeking physiological ventricular pacing.
机构信息
Arrhythmia and Pacing Unit, 'Juan Ramón Jiménez' Hospital, Huelva, Spain.
出版信息
Europace. 2010 Apr;12(4):527-33. doi: 10.1093/europace/euq038.
AIMS
Right ventricular apical pacing can have deleterious effects and the His bundle has been widely reported to be an alternative site. This paper presents our experience with permanent His-bundle pacing (HBP).
METHODS AND RESULTS
Patients referred for pacemaker implants (regardless of block type) were screened to determine if temporary HBP corrected conduction dysfunctions (threshold < or =2.5 V for 1 ms) and provided infra-Hisian 1:1 conduction of at least 120 s/m. Of the 182 patients selected, HBP corrected conduction dysfunctions in 133 (73%) patients, 42 (32%) of whom were rejected for the permanent procedure due to high thresholds. His-bundle lead implantation was attempted in the remaining 91 patients and was successful in 59 (65% of all attempts, 44% of all possible cases).
CONCLUSION
In some patients, permanent HBP may be an alternative to right ventricular apical pacing.
目的
右心室心尖部起搏可能会产生有害影响，希氏束已被广泛报道为替代部位。本文介绍了我们在永久性希氏束起搏（HBP）方面的经验。
方法和结果
对因起搏器植入（无论阻滞类型如何）而就诊的患者进行筛选，以确定临时 HBP 是否纠正了传导功能障碍（阈值<或=2.5 V 时为 1 ms），并提供至少 120 s/m 的希氏下 1:1 传导。在选择的 182 例患者中，133 例（73%）患者的传导功能障碍得到纠正，其中 42 例（32%）由于阈值较高而被排除在永久性手术之外。对其余 91 例患者尝试进行希氏束导线植入，其中 59 例（所有尝试的 65%，所有可能情况的 44%）成功。
结论
在某些患者中，永久性 HBP 可能是右心室心尖部起搏的替代方法。
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