Department of Cardiology, Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy.
Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, 40138 Bologna, Italy.
Rev Cardiovasc Med. 2022 Mar 17;23(3):107. doi: 10.31083/j.rcm2303107.
Cardiac simulation has moved from early life-saving pacemakers meant only to prevent asystole to current devices capable of physiologic stimulation for the treatment of heart rhythm and heart failure, that are also intended for remote patient and disease-progression monitoring. The actual vision of contemporary pacing aims to correct the electrophysiologic roots of mechanical inefficiency regardless of underlying structural heart diseases. The awareness of the residual cardiac dyssynchrony related to customary cardiac pacing has changed the concept of what truly represents "physiologic pacing". On a different perspective, leadless stimulation to abolish CIED surgery and prevent lead-related complications is becoming a priority both for young device recipients and for frail, elderly patients. Careful clinical evaluation attempts to bridge decision-making to patient-tailored therapy.
心脏模拟已经从早期仅用于防止停搏的救生起搏器发展到目前能够进行生理刺激以治疗心律失常和心力衰竭的设备，这些设备也旨在用于远程患者和疾病进展监测。当代起搏的实际目标是纠正机械效率低下的电生理根源，而不管潜在的结构性心脏病如何。对与常规心脏起搏相关的残余心脏不同步的认识改变了真正代表“生理起搏”的概念。从另一个角度来看，无导线刺激以消除 CIED 手术并预防与导线相关的并发症，这对于年轻的设备接受者和体弱的老年患者来说都变得至关重要。仔细的临床评估试图将决策与患者个体化治疗联系起来。
