Zipse Matthew M, Groves Daniel W, Khanna Amber D, Nguyen Duy Thai
Cardiac Electrophysiology, Cardiology Division, University of Colorado, Denver, Anschutz Medical Campus, 12401 East 17th Avenue, B-132, Aurora, CO 80045, USA.
Cardiac Electrophysiology, Cardiology Division, University of Colorado, Denver, Anschutz Medical Campus, 12401 East 17th Avenue, B-132, Aurora, CO 80045, USA.
Card Electrophysiol Clin. 2016 Mar;8(1):169-71. doi: 10.1016/j.ccep.2015.10.020. Epub 2016 Jan 13.
In the presence of a mechanical tricuspid valve, endocardial right ventricular pacing is contraindicated, and permanent pacing is usually achieved via a surgically implanted epicardial lead. In a patient with Ebstein anomaly, a mechanical tricuspid valve, and complete heart block, transvenous pacing was achieved by implantation of a pace-sense lead in a coronary sinus ventricular branch. Noninvasive cardiac imaging can provide information regarding anatomic variation in patients with congenital heart disease or when there are challenges to lead placement. With careful planning and execution, endovascular pacing in patients with a mechanical tricuspid valve is feasible and can safely be performed.
对于存在机械性三尖瓣的患者，心内膜右心室起搏是禁忌的，永久性起搏通常通过手术植入的心外膜导线来实现。对于一名患有埃布斯坦畸形、机械性三尖瓣且完全性心脏传导阻滞的患者，通过在冠状窦心室分支植入一根感知起搏导线实现了经静脉起搏。无创心脏成像可以提供有关先天性心脏病患者解剖变异的信息，或在导线置入存在挑战时提供相关信息。经过精心规划和实施，对于存在机械性三尖瓣的患者，血管内起搏是可行的，并且可以安全地进行。
