Sundaram Chandrasekar, Kartik S Viswanatha, Namboodiri Narayanan, Ajitkumar Valaparambil K
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, India.
Department of Cardiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, Kerala, 695011, India.
Indian Pacing Electrophysiol J. 2021 Sep-Oct;21(5):303-307. doi: 10.1016/j.ipej.2021.05.007. Epub 2021 May 24.
Endomyocardial fibrosis (EMF) is characterized by fibrous tissue deposition on the endocardial surface leading to impaired filling of one or both ventricles, resulting in either right or left heart failure or both. Although Sinus node dysfunction and tachyarrhythmia - atrial fibrillation, ventricular tachycardia, have been commonly reported, complete heart block (CHB) necessitating a pacemaker is rare in EMF. Transvenous pacing is technically limited by fibrotic obliteration of the affected ventricle that results in poor lead parameters, and alternative pacing strategy like epicardial pacing may be required in many. We report three cases of EMF, who were treated with an alternative pacing strategy.
心内膜心肌纤维化（EMF）的特征是心内膜表面有纤维组织沉积，导致一个或两个心室充盈受损，进而引起右心衰竭或左心衰竭，或两者皆有。虽然窦性心律失常和快速性心律失常——心房颤动、室性心动过速，已有常见报道，但在EMF中需要起搏器治疗的完全性心脏传导阻滞（CHB）很少见。经静脉起搏在技术上受到受影响心室纤维化闭塞的限制，这会导致起搏参数不佳，许多患者可能需要采用如心外膜起搏等替代起搏策略。我们报告了3例采用替代起搏策略治疗的EMF患者。
