Hattori Yusuke, Ishibashi Kohei, Noda Takashi, Okamura Hideo, Kanzaki Hideaki, Anzai Toshihisa, Yasuda Satoshi, Kusano Kengo
Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center, Japan.
Department of Cardiovascular Medicine, Wakayama Medical University, Japan.
Intern Med. 2017 Sep 1;56(17):2285-2288. doi: 10.2169/internalmedicine.8458-16. Epub 2017 Aug 10.
We describe the case of a 37-year-old woman who presented with complete right bundle branch block and right axis deviation. She was admitted to our hospital due to severe heart failure and was dependent on inotropic agents. Cardiac resynchronization therapy was initiated but did not improve her condition. After the optimization of the pacing timing, we performed earlier right ventricular pacing, which led to an improvement of her heart failure. Earlier right ventricular pacing should be considered in patients with complete right bundle branch block and right axis deviation when cardiac resynchronization therapy is not effective.
我们描述了一名37岁女性的病例，她表现为完全性右束支传导阻滞和电轴右偏。她因严重心力衰竭入院，依赖于正性肌力药物。开始进行心脏再同步治疗，但病情未改善。在优化起搏时机后，我们进行了更早的右心室起搏，这使她的心力衰竭得到改善。当心脏再同步治疗无效时，对于患有完全性右束支传导阻滞和电轴右偏的患者，应考虑更早进行右心室起搏。
