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一项分析左束支区域起搏在幼儿中应用的可行性和有效性的研究。

A Study to Analyse the Feasibility and Effectiveness of Left Bundle Branch Area Pacing Used in Young Children.

机构信息

Department of Paediatric Cardiology, Heart Center, The First Hospital of Tsinghua University (Beijing Huaxin Hospital), No.6, Jiuxianqiao 1st Road, Chaoyang, Beijing, 100016, China.

School of Clinical Medicine, Tsinghua University, Beijing, China.

出版信息

Pediatr Cardiol. 2024 Mar;45(3):681-689. doi: 10.1007/s00246-023-03119-8. Epub 2023 Feb 25.

Abstract

This study aimed to investigate the feasibility and effectiveness of left bundle branch area pacing (LBBaP) in young children. From September 2020 to May 2021, a total of 31 children (≤ 7 years) with complete atrioventricular block were included. All patients were scheduled to undergo LBBaP. Pacing parameters, and cardiac function and synchrony were evaluated during follow-up. LBBaP succeeded in 21 children (3.3 ± 2.1 years old), with a success rate of 70.9%. LBBaP failed in nine children, who eventually received right ventricular septal pacing (RVSP). The average postoperative QRS duration in patients of LBBaP group was narrower than that of RVSP group: 100.9 ± 9.1 versus 114.2 ± 11.9 ms (P = 0.002). The median follow-up duration was 12 [interquartile range (IQR) 6-15] months. At last time of follow-up, the capture threshold of ventricular electrode in patients of LBBaP group were significantly lower than that of RVSP group (0.70 ± 0.25 versus 1.39 ± 0.94 V, P = 0.011). The echo-left ventricular ejection fraction (LVEF) in patients in the LBBaP group was better than that in the RVSP group (66.1 ± 3.3 versus 63.1 ± 2.2%, P = 0.025). LBBaP can be safely and effectively administered in young children. Satisfactory pacing parameters, and narrow QRS durations were obtained.

摘要

本研究旨在探讨左束支区域起搏(LBBaP)在幼儿中的可行性和有效性。2020 年 9 月至 2021 年 5 月,共纳入 31 例(≤7 岁)完全性房室传导阻滞患儿。所有患者均计划行 LBBaP。随访期间评估起搏参数、心功能和同步性。LBBaP 成功 21 例(3.3±2.1 岁),成功率为 70.9%。LBBaP 失败 9 例,最终行右室间隔部起搏(RVSP)。LBBaP 组术后 QRS 时限较 RVSP 组更窄:100.9±9.1 比 114.2±11.9 ms(P=0.002)。LBBaP 组中位随访时间为 12 个月(IQR 6-15)。最后一次随访时,LBBaP 组心室电极的夺获阈值明显低于 RVSP 组(0.70±0.25 比 1.39±0.94 V,P=0.011)。LBBaP 组的左室射血分数(LVEF)优于 RVSP 组(66.1±3.3 比 63.1±2.2%,P=0.025)。LBBaP 可安全有效地应用于幼儿。获得了满意的起搏参数和较窄的 QRS 时限。

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