Scheffer M, van Gelder B
Neth Heart J. 2003 Sep;11(9):359-361.
The preference for treatment of symptomatic bradycardia is transvenous right ventricular pacing combined with atrial synchronisation if applicable. In the case of congenital anomalies where no conduit is present between the peripheral veins and the right ventricle, it is not possible to place the ventricular pacing lead in the right ventricle. Also the presence of an artificial valve in the tricuspid position excludes placement of an endocardial right ventricular pacing lead. Since the introduction of biventricular pacing, new guiding catheters and leads used as a transvenous route for left ventricular pacing are available. We report implantation of a ventricular pacing lead in the great cardiac vein for permanent ventricular pacing in a patient with a tricuspid valve prosthesis.
对于有症状的心动过缓，首选治疗方法是经静脉右心室起搏，如适用可联合心房同步起搏。对于外周静脉与右心室之间不存在导管的先天性异常情况，无法将心室起搏导线置于右心室内。此外，三尖瓣位置存在人工瓣膜也排除了心内膜右心室起搏导线的置入。自从双心室起搏引入以来，有了新的引导导管和用作左心室起搏经静脉途径的导线。我们报告了在一名有三尖瓣人工瓣膜的患者中，将心室起搏导线植入心大静脉以进行永久性心室起搏的情况。
