von Alvensleben Johannes C, Pinder Marco A, Brateng Caitlin, Mitchell Max, Collins Kathryn K
Department of Pediatrics, Division of Cardiology, University of Colorado, Children's Hospital Colorado, Aurora, CO, USA.
Department of Surgery, Division of Cardiac Surgery, University of Colorado, Children's Hospital Colorado Aurora, CO, USA.
J Innov Card Rhythm Manag. 2019 Dec 15;10(12):3937-3939. doi: 10.19102/icrm.2019.101205. eCollection 2019 Dec.
Cardiac resynchronization therapy (CRT) is used as an adjunctive therapy in adults with advanced heart failure but remains less commonly applied in pediatric patients. Further, CRT is traditionally conducted via biventricular transvenous pacing from the right ventricle and coronary sinus to activate the left ventricle and improve electromechanical synchrony; however, triventricular pacing, in which a third ventricular lead is utilized to activate an additional ventricular location, has been shown to be a feasible therapeutic alternative to typical CRT in patients with advanced heart failure or nonresponders. Limited adult studies involving triventricular pacing have been performed to date but no pediatric data are available. Thus, we present the case of a 12-month-old patient with congenital complete heart block and subsequent pacemaker-induced cardiomyopathy in whom triventricular epicardial pacing was applied in an effort to increase the available knowledge.
心脏再同步治疗（CRT）被用作晚期心力衰竭成人患者的辅助治疗，但在儿科患者中应用较少。此外，传统上CRT是通过从右心室和冠状窦进行双心室经静脉起搏来激活左心室并改善机电同步性；然而，三心室起搏，即利用第三根心室导线激活额外的心室部位，已被证明是晚期心力衰竭患者或无反应者中典型CRT的一种可行治疗替代方案。迄今为止，涉及三心室起搏的成人研究有限，但尚无儿科数据。因此，我们报告了一例12个月大患有先天性完全性心脏传导阻滞及随后起搏器诱发的心肌病的患者，对其应用了三心室心外膜起搏，以增加现有知识。
