Teratani Hiromitsu, Fujimatsu Toshihiro, Suzuki Hiroyuki, Tashiro Tadashi
Division of Cardiovascular Surgery, Heart Center, Hokuto Hospital, Obihiro, Japan.
Kyobu Geka. 2015 Aug;68(9):748-51.
A 57-year-old man was diagnosed with dilated cardiomyopathy and coronary stenosis. His electrocardiogram showed a complete left bundle branch block and a prolonged QRS interval. As appropriate medical therapy improved his symptoms, he did not visit out-patient clinic after discharge. A year later, he presented with exertional chest oppression and was readmitted with severe heart failure. Although medical therapy was provided, his condition did not improve. Left ventricular systolic dysfunction and stenosis of the left anterior descending artery were aggravated. We performed coronary artery bypass grafting and biventricular pacing with surgical epicardial leads, which led to improvement in left ventricular systolic function. We consider that biventricular pacing with surgical epicardial leads is a potential option in cases of open heart surgery requiring cardiac resynchronization therapy for severe left ventricular systolic dysfunction.
一名57岁男性被诊断为扩张型心肌病和冠状动脉狭窄。他的心电图显示完全性左束支传导阻滞和QRS间期延长。随着适当的药物治疗改善了他的症状，他出院后未到门诊就诊。一年后，他出现劳力性胸部压迫感，因严重心力衰竭再次入院。尽管给予了药物治疗，但其病情并未改善。左心室收缩功能障碍和左前降支动脉狭窄加重。我们进行了冠状动脉旁路移植术和使用外科心外膜导联的双心室起搏，这使左心室收缩功能得到改善。我们认为，对于需要心脏再同步治疗的严重左心室收缩功能障碍的心脏直视手术病例，使用外科心外膜导联进行双心室起搏是一种潜在的选择。
