一种采用J型钢丝自主改良进行巴赫曼束起搏的简单方法。
A simple method for Bachmann's bundle pacing with indigenous modification of J-stylet.
作者信息
Das Asit, Banerjee Suvro, Mandal S C
机构信息
RMO-cum-Clinical Tutor, Department of Cardiology, IPGME&R and SSKM Hospital, Kolkata, India.
Senior Interventional Cardiologist, Apollo Gleneagles Hospitals, Kolkata, India.
出版信息
Indian Heart J. 2016 Sep-Oct;68(5):678-684. doi: 10.1016/j.ihj.2015.10.299. Epub 2016 Jan 11.
BACKGROUND
Pacing in the Bachmann's bundle (BB) area (upper atrial septum) appears superior to right atrial appendage or free wall stimulation for the prevention of paroxysmal atrial fibrillation in patients with atrial conduction delay. However, insertion of active fixation lead in the upper atrial septal position is difficult and time consuming with conventional stylet, inhibiting application of this pacing method in routine practice.
METHODS
The technique of positioning the atrial lead in BB with hand-made stylet is presented with emphasis on electrocardiographic P-wave pattern and fluoroscopic landmarks.
RESULTS
The results demonstrate an acute implantation and short-term success of BB pacing of 14 patients out of 15 patients without major complications. Pacing parameters at implantation and 3 months postprocedure were noted which were within normal limits.
CONCLUSION
These favorable initial results indicate that the positioning of active fixation atrial lead in BB with fluoroscopic landmarks is feasible and reproducible with a simple technique.
背景
对于存在心房传导延迟的患者，在巴赫曼束（BB）区域（房间隔上部）进行起搏似乎优于右心耳或游离壁刺激，以预防阵发性心房颤动。然而，使用传统的引导钢丝在房间隔上部位置插入主动固定导线既困难又耗时，这限制了这种起搏方法在常规实践中的应用。
方法
介绍了使用自制引导钢丝将心房导线定位在BB的技术，重点强调心电图P波形态和透视标志。
结果
结果显示15例患者中有14例成功进行了BB起搏的急性植入且无重大并发症，短期成功率高。记录了植入时和术后3个月的起搏参数，均在正常范围内。
结论
这些良好的初步结果表明，借助透视标志使用简单技术将主动固定心房导线定位在BB是可行且可重复的。
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