Kashubian Center for Heart and Vascular Diseases, Department of Cardiology and Interventional Angiology, Pomeranian Hospitals, 84-200 Wejherowo, Poland.
Department of Cardiology and Electrotherapy, Medical University of Gdansk, 80-214 Gdansk, Poland.
Int J Environ Res Public Health. 2021 Nov 8;18(21):11721. doi: 10.3390/ijerph182111721.
We compared the effects of right ventricular (RVP; = 26) and His bundle (HBP; = 24) pacing in patients with atrioventricular conduction disorders and preserved LVEF. Postoperatively (1D), and after six months (6M), the patients underwent global longitudinal strain (GLS) and peak systolic dispersion (PSD) evaluation with 2D speckle-tracking echocardiography, assessment of left atrial volume index (LAVI) and QRS duration (QRSd), and sensing/pacing parameter testing. The RVP threshold was lower than the HBP threshold at 1D (0.65 ± 0.13 vs. 1.05 ± 0.20 V, < 0.001), and then it remained stable, while the HBP threshold increased at 6M (1.05 ± 0.20 vs. 1.31 ± 0.30 V, < 0.001). The RVP R-wave was higher than the HBP R-wave at 1D (11.52 ± 2.99 vs. 4.82 ± 1.41 mV, < 0.001). The RVP R-wave also remained stable, while the HBP R-wave decreased at 6M (4.82 ± 1.41 vs. 4.50 ± 1.09 mV, < 0.02). RVP QRSd was longer than HBP QRSd at 6M (145.0 ± 11.1 vs. 112.3 ± 9.3 ms, < 0.001). The absolute value of RVP GLS decreased at 6M (16.32 ± 2.57 vs. 14.03 ± 3.78%, < 0.001), and HBP GLS remained stable. Simultaneously, RVP PSD increased (72.53 ± 24.15 vs. 88.33 ± 30.51 ms, < 0.001) and HBP PSD decreased (96.28 ± 33.99 vs. 84.95 ± 28.98 ms, < 0.001) after 6 months. RVP LAVI increased (26.73 ± 5.7 vs. 28.40 ± 6.4 mL/m, < 0.05), while HBP LAVI decreased at 6M (30.03 ± 7.8 vs. 28.73 ± 8.7 mL/m, < 0.01). These results confirm that HBP does not disrupt ventricular synchrony and provides advantages over RVP.
我们比较了右心室（RVP；n = 26）和希氏束（HBP；n = 24）起搏在房室传导障碍和保留左心室射血分数（LVEF）的患者中的作用。术后 1 天（1D）和 6 个月（6M）时，患者接受二维斑点追踪超声心动图评估整体纵向应变（GLS）和收缩期峰值离散度（PSD）、左心房容积指数（LAVI）和 QRS 持续时间（QRSd）评估，以及感知/起搏参数测试。1D 时 RVP 阈值低于 HBP 阈值（0.65 ± 0.13 对 1.05 ± 0.20V，<0.001），随后保持稳定，而 HBP 阈值在 6M 时增加（1.05 ± 0.20 对 1.31 ± 0.30V，<0.001）。1D 时 RVP R 波高于 HBP R 波（11.52 ± 2.99 对 4.82 ± 1.41mV，<0.001）。RVP R 波也保持稳定，而 HBP R 波在 6M 时降低（4.82 ± 1.41 对 4.50 ± 1.09mV，<0.02）。6M 时 RVP QRSd 长于 HBP QRSd（145.0 ± 11.1 对 112.3 ± 9.3ms，<0.001）。6M 时 RVP GLS 的绝对值下降（16.32 ± 2.57 对 14.03 ± 3.78%，<0.001），而 HBP GLS 保持稳定。同时，RVP PSD 增加（72.53 ± 24.15 对 88.33 ± 30.51ms，<0.001），HBP PSD 降低（96.28 ± 33.99 对 84.95 ± 28.98ms，<0.001）6 个月后。RVP LAVI 增加（26.73 ± 5.7 对 28.40 ± 6.4mL/m，<0.05），而 HBP LAVI 在 6M 时降低（30.03 ± 7.8 对 28.73 ± 8.7mL/m，<0.01）。这些结果证实，HBP 不会破坏心室同步性，并优于 RVP。
