Marcantoni Lina, Zuin Marco, Baracca Enrico, Pastore Gianni, Raffagnato Paola, Tiribello Antonella, Boaretto Graziano, Zanon Francesco
Arrhythmia and Electrophysiology Unit, Dept of Cardiology, Santa Maria della Misericordia General Hospital, Rovigo, Italy.
Herzschrittmacherther Elektrophysiol. 2020 Jun;31(2):111-116. doi: 10.1007/s00399-020-00681-z. Epub 2020 May 6.
His bundle pacing (HBP) preserves physiological ventricular synchrony, with clinical benefits particularly evident when a high percentage of ventricular pacing is required. First experiences with standard leads and manually shaped stylets produced the impression that HBP is highly complex and time-consuming. However, with dedicated leads and sheaths, reliable HBP can be achieved in routine clinical practice. Implantation success in more than 90% of patients can be reached with current technology and has been shown to be reliable and effective, both at implantation and during long-term follow-up. At the same time, fluoroscopy and total procedural time can be reduced. New customized technologies will continue to improve the implant success rate and system performance. Large randomized trials will prove the long-term clinical benefits of HBP definitively and may render HBP the first choice in patients requiring ventricular pacing.
希氏束起搏（HBP）可维持生理性心室同步性，当需要较高比例的心室起搏时，其临床益处尤为明显。最初使用标准导线和手工塑形的探子进行希氏束起搏时，给人的印象是该操作极为复杂且耗时。然而，使用专用导线和鞘管，在常规临床实践中即可实现可靠的希氏束起搏。采用当前技术，超过90%的患者可成功植入，且已证明在植入时及长期随访中均可靠且有效。同时，可减少透视时间和整个手术过程的时间。新的定制技术将持续提高植入成功率和系统性能。大型随机试验将最终证实希氏束起搏的长期临床益处，并可能使希氏束起搏成为需要心室起搏患者的首选。
