Department of Cardiology, The Key Lab of Cardiovascular Disease of Wenzhou, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Ultrasonography, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.
Can J Cardiol. 2016 Dec;32(12):1577.e1-1577.e4. doi: 10.1016/j.cjca.2015.10.024. Epub 2015 Nov 10.
The optimal pacing modality after atrioventricular junction (AVJ) ablation remains unclear. Herein, we describe the case of a heart failure patient who had AVJ ablation for chronic atrial fibrillation and received a cardiac resynchronization therapy defibrillator device. Because of the lack of clinical response to biventricular pacing, the device was revised with the addition of direct His bundle pacing, which resulted in significant improvement in functional status and left ventricular indices. This case illustrated direct His bundle pacing as an alternative for conventional biventricular pacing in some cardiac resynchronization therapy nonresponders who undergo AVJ ablation for atrial fibrillation and have an intact distal conduction system.
房室结（AVJ）消融后最佳起搏模式仍不清楚。在此，我们描述了 1 例因慢性心房颤动行 AVJ 消融并植入心脏再同步治疗除颤器的心力衰竭患者。由于双心室起搏无临床反应，该装置进行了修订，增加了直接希氏束起搏，这导致功能状态和左心室指数显著改善。该病例说明了对于因心房颤动而行 AVJ 消融且远端传导系统完整的心脏再同步治疗无反应者，直接希氏束起搏可作为传统双心室起搏的替代方法。
