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病例报告:采用永久性希氏束起搏及房室结消融治疗心动过速诱发的心源性休克。

Case report: Treatment of tachycardia-induced cardiogenic shock with permanent His bundle pacing and atrioventricular node ablation.

作者信息

Žlahtič Tadej, Fister Miša, Radšel Peter, Noč Marko, Šinkovec Matjaž, Žižek David

机构信息

Department of Cardiology, University Medical Centre Ljubljana, Ljubljana, Slovenia.

Department of Intensive Internal Medicine, University Medical Centre Ljubljana, Ljubljana, Slovenia.

出版信息

Front Cardiovasc Med. 2022 Nov 14;9:992675. doi: 10.3389/fcvm.2022.992675. eCollection 2022.

Abstract

Tachycardia-induced cardiomyopathy (T-CMP) related to supraventricular arrhythmia is a rare and often unrecognized cause of refractory cardiogenic shock. When rhythm control interventions are ineffective or no longer pursued, atrioventricular node ablation (AVNA) with pacemaker implantation is indicated. Conduction system pacing provides normal synchronous activation of the ventricles after AVNA. However, there is a lack of data on pace and ablate strategy in hemodynamically unstable patients. We report on 2 patients with T-CMP presenting with refractory cardiogenic shock who were successfully treated with His bundle pacing in conjunction with AVNA.

摘要

与室上性心律失常相关的心动过速性心肌病(T-CMP)是难治性心源性休克的一种罕见且常未被认识的病因。当节律控制干预无效或不再采用时,应进行房室结消融(AVNA)并植入起搏器。房室结消融后,传导系统起搏可使心室正常同步激活。然而,关于血流动力学不稳定患者的起搏和消融策略的数据尚缺乏。我们报告2例患有T-CMP并出现难治性心源性休克的患者,他们通过希氏束起搏联合房室结消融成功得到治疗。

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