希氏束起搏：心力衰竭治疗的新前沿。
His Bundle Pacing: A New Frontier in the Treatment of Heart Failure.
作者信息
Ali Nadine, Keene Daniel, Arnold Ahran, Shun-Shin Matthew, Whinnett Zachary I, Afzal Sohaib S M
机构信息
National Heart and Lung Institute, Imperial College London, UK.
出版信息
Arrhythm Electrophysiol Rev. 2018 Jun;7(2):103-110. doi: 10.15420/aer.2018.6.2.
Abstract
Biventricular pacing has revolutionised the treatment of heart failure in patients with sinus rhythm and left bundle branch block; however, left ventricular-lead placement is not always technically possible. Furthermore, biventricular pacing does not fully normalise ventricular activation and, therefore, the ventricular resynchronisation is imperfect. Right ventricular pacing for bradycardia may cause or worsen heart failure in some patients by causing dyssynchronous ventricular activation. His bundle pacing activates the ventricles via the native His-Purkinje system, resulting in true physiological pacing, and, therefore, is a promising alternate site for pacing in bradycardia and traditional CRT indications in cases where it can overcome left bundle branch block. Furthermore, it may open up new indications for pacing therapy in heart failure, such as targeting patients with PR prolongation, but a narrow QRS duration. In this article we explore the physiology, technology and potential roles of His bundle pacing in the prevention and treatment of heart failure.
摘要
双心室起搏彻底改变了窦性心律和左束支传导阻滞患者的心力衰竭治疗方式；然而，左心室导线置入在技术上并非总是可行。此外，双心室起搏并不能完全使心室激动正常化，因此心室再同步并不完美。用于治疗心动过缓的右心室起搏可能会导致心室激动不同步，从而在一些患者中引起或加重心力衰竭。希氏束起搏通过天然的希氏-浦肯野系统激活心室，实现真正的生理性起搏，因此，在能够克服左束支传导阻滞的情况下，对于心动过缓和传统心脏再同步治疗（CRT）适应证而言，它是一个有前景的起搏替代部位。此外，它可能为心力衰竭的起搏治疗开辟新的适应证，比如针对PR间期延长但QRS波时限狭窄的患者。在本文中，我们探讨希氏束起搏在心力衰竭预防和治疗中的生理学、技术及潜在作用。
相似文献
1
His Bundle Pacing: A New Frontier in the Treatment of Heart Failure.希氏束起搏：心力衰竭治疗的新前沿。
Arrhythm Electrophysiol Rev. 2018 Jun;7(2):103-110. doi: 10.15420/aer.2018.6.2.
2
Atrioventricular Optimized Direct His Bundle Pacing Improves Acute Hemodynamic Function in Patients With Heart Failure and PR Interval Prolongation Without Left Bundle Branch Block.房室优化直接希氏束起搏可改善无左束支传导阻滞的心力衰竭和PR间期延长患者的急性血流动力学功能。
JACC Clin Electrophysiol. 2015 Dec;1(6):582-591. doi: 10.1016/j.jacep.2015.08.008. Epub 2015 Oct 23.
3
Electrocardiographic follow-up of biventricular pacemakers.双心室起搏器的心电图随访
Ann Noninvasive Electrocardiol. 2005 Apr;10(2):231-55. doi: 10.1111/j.1542-474X.2005.10201.x.
4
Left Bundle Branch Pacing: JACC Review Topic of the Week.左束支起搏：JACC 本周专题
J Am Coll Cardiol. 2019 Dec 17;74(24):3039-3049. doi: 10.1016/j.jacc.2019.10.039. Epub 2019 Dec 9.
5
His bundle pacing shows similar ventricular electrical activation as sinus: selective and nonselective His pacing indistinguishable.希氏束起搏表现出与窦性心律相似的心室电激动：选择性和非选择性希氏束起搏无法区分。
Am J Physiol Heart Circ Physiol. 2021 Jan 1;320(1):H13-H22. doi: 10.1152/ajpheart.00292.2020. Epub 2020 Oct 30.
6
His Resynchronization Versus Biventricular Pacing in Patients With Heart Failure and Left Bundle Branch Block.心力衰竭伴左束支传导阻滞患者的再同步化治疗与双心室起搏。
J Am Coll Cardiol. 2018 Dec 18;72(24):3112-3122. doi: 10.1016/j.jacc.2018.09.073.
7
Permanent His bundle pacing to replace biventricular pacing for cardiac resynchronization therapy.永久希氏束起搏替代双心室起搏用于心脏再同步治疗。
Med Hypotheses. 2017 Nov;109:77-79. doi: 10.1016/j.mehy.2017.09.026. Epub 2017 Sep 28.
8
[Management of heart failure with His bundle pacing in right bundle branch block: case report].[右束支传导阻滞患者希氏束起搏治疗心力衰竭：病例报告]
Arch Cardiol Mex. 2021;91(1):93-99. doi: 10.24875/ACM.19000402.
9
Permanent His-bundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy: A multicenter experience.永久希氏束起搏作为心脏再同步治疗的一种替代方法：多中心经验。
Heart Rhythm. 2018 Mar;15(3):413-420. doi: 10.1016/j.hrthm.2017.10.014. Epub 2017 Oct 12.
10
Bilateral Bundle Branch Area Pacing to Achieve Physiological Conduction System Activation.双侧束支区域起搏以实现生理性传导系统激活。
Circ Arrhythm Electrophysiol. 2020 Aug;13(8):e008267. doi: 10.1161/CIRCEP.119.008267. Epub 2020 Jul 23.
引用本文的文献
1
Authors' Reply: His Bundle Pacing: A New Frontier in the Treatment of Heart Failure.作者回复：希氏束起搏：心力衰竭治疗的新前沿。
Arrhythm Electrophysiol Rev. 2018 Aug;7(3):218-219. doi: 10.15420/aer.2018.7.3.L1.R1.
2
Injectable hydrogel electrodes as conduction highways to restore native pacing.可注射水凝胶电极作为恢复固有起搏的传导高速公路。
Nat Commun. 2024 Jan 2;15(1):64. doi: 10.1038/s41467-023-44419-0.
3
[Follow-up of the patient with pacemakers: Interrogation and basic programming].[起搏器植入患者的随访：问询与基本程控]
Rev Med Inst Mex Seguro Soc. 2023 Nov 6;61(6):809-818. doi: 10.5281/zenodo.10064399.
4
Conduction system pacing: how far are we from the "electrical" bypass?传导系统起搏：我们离“电旁路”还有多远？
Heart Fail Rev. 2024 Jan;29(1):45-63. doi: 10.1007/s10741-023-10349-8. Epub 2023 Sep 30.
5
Transcatheter Aortic Valve Implantation and Cardiac Conduction Abnormalities: Prevalence, Risk Factors and Management.经导管主动脉瓣植入术与心脏传导异常：患病率、危险因素及管理
J Clin Med. 2023 Sep 19;12(18):6056. doi: 10.3390/jcm12186056.
6
Prognostic Impact of the Increase in Cardiac Troponin Levels during Tafamidis Therapy in Patients with Transthyretin Cardiac Amyloidosis.在转甲状腺素蛋白心脏淀粉样变患者中，塔非酰胺治疗期间心肌肌钙蛋白水平升高的预后影响
J Clin Med. 2023 Jul 12;12(14):4631. doi: 10.3390/jcm12144631.
7
Conduction system pacing: promoting the physiology to prevent heart failure.心脏传导系统起搏：促进生理学以预防心力衰竭。
Heart Fail Rev. 2023 Mar;28(2):379-386. doi: 10.1007/s10741-023-10296-4. Epub 2023 Feb 14.
8
A New Electromechanical Wave Imaging Dispersion Metric for the Characterization of Ventricular Activation in Different Cardiac Resynchronization Therapy Pacing Schemes.一种用于不同心脏再同步治疗起搏方案中心室激活特征分析的新机电波成像频散度量。
IEEE Trans Biomed Eng. 2023 Mar;70(3):853-859. doi: 10.1109/TBME.2022.3203653. Epub 2023 Feb 17.
9
Conduction System Pacing in Pediatrics and Congenital Heart Disease, a Single Center Series of 24 Patients.儿科和先天性心脏病的传导系统起搏：单中心 24 例系列研究。
Pediatr Cardiol. 2024 Aug;45(6):1165-1171. doi: 10.1007/s00246-022-02942-9. Epub 2022 Jun 9.
10
[ESC guidelines 2021 on cardiac pacing and cardiac resynchronization therapy : What's new?].[2021年欧洲心脏病学会心脏起搏与心脏再同步治疗指南：有哪些新内容？]
Herz. 2022 Feb;47(1):31-40. doi: 10.1007/s00059-021-05089-0. Epub 2022 Jan 10.
本文引用的文献
1
Atrioventricular Optimized Direct His Bundle Pacing Improves Acute Hemodynamic Function in Patients With Heart Failure and PR Interval Prolongation Without Left Bundle Branch Block.房室优化直接希氏束起搏可改善无左束支传导阻滞的心力衰竭和PR间期延长患者的急性血流动力学功能。
JACC Clin Electrophysiol. 2015 Dec;1(6):582-591. doi: 10.1016/j.jacep.2015.08.008. Epub 2015 Oct 23.
2
Clinical Outcomes of His Bundle Pacing Compared to Right Ventricular Pacing.希氏束起搏与右心室起搏的临床转归比较。
J Am Coll Cardiol. 2018 May 22;71(20):2319-2330. doi: 10.1016/j.jacc.2018.02.048. Epub 2018 Mar 10.
3
Permanent His-bundle pacing: Long-term lead performance and clinical outcomes.永久性希氏束起搏：长期导线性能和临床结局。
Heart Rhythm. 2018 May;15(5):696-702. doi: 10.1016/j.hrthm.2017.12.022. Epub 2017 Dec 20.
4
Atrioventricular node ablation and His bundle pacing.房室结消融和希氏束起搏。
Europace. 2017 Dec 1;19(suppl_4):iv10-iv16. doi: 10.1093/europace/eux263.
5
Permanent His bundle pacing: Recommendations from a Multicenter His Bundle Pacing Collaborative Working Group for standardization of definitions, implant measurements, and follow-up.永久性希氏束起搏：多中心希氏束起搏协作工作组的建议，用于标准化定义、植入测量和随访。
Heart Rhythm. 2018 Mar;15(3):460-468. doi: 10.1016/j.hrthm.2017.10.039. Epub 2017 Oct 28.
6
Beneficial effects of upgrading to His bundle pacing in chronically paced patients with left ventricular ejection fraction <50.升级为希氏束起搏对左心室射血分数<50%的慢性起搏患者的有益影响。
Heart Rhythm. 2018 Mar;15(3):405-412. doi: 10.1016/j.hrthm.2017.10.031. Epub 2017 Nov 16.
7
Permanent His-bundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy: A multicenter experience.永久希氏束起搏作为心脏再同步治疗的一种替代方法：多中心经验。
Heart Rhythm. 2018 Mar;15(3):413-420. doi: 10.1016/j.hrthm.2017.10.014. Epub 2017 Oct 12.
8
Benefits of Permanent His Bundle Pacing Combined With Atrioventricular Node Ablation in Atrial Fibrillation Patients With Heart Failure With Both Preserved and Reduced Left Ventricular Ejection Fraction.永久性希氏束起搏联合房室结消融治疗左心室射血分数保留和降低的心力衰竭伴心房颤动患者的获益。
J Am Heart Assoc. 2017 Apr 1;6(4):e005309. doi: 10.1161/JAHA.116.005309.
9
Hyper-response to cardiac resynchronization with permanent His bundle pacing: Is parahisian pacing sufficient?永久希氏束起搏对心脏再同步治疗的高反应：希氏束旁起搏是否足够？
HeartRhythm Case Rep. 2015 Nov;1(6):429-433. doi: 10.1016/j.hrcr.2015.05.006. Epub 2015 Sep 3.
10
Permanent His-bundle pacing in patients with prosthetic cardiac valves.人工心脏瓣膜患者的永久性希氏束起搏
Heart Rhythm. 2017 Jan;14(1):59-64. doi: 10.1016/j.hrthm.2016.09.016. Epub 2016 Sep 20.
Zotero 插件