Nohno Yasumasa, Fujiu Katsuhito, Kozu Ryosuke, Maruyama Shusaku, Hasegawa Tomoya, Tsuchiya Hiromi, Yanagisawa Takashi, Tachibana Takahiro, Kimura Hikaru, Yazaki Yoshikazu
Department of Cardiology, Saku Central Hospital Advanced Care Center.
Department of Cardiovascular Medicine, The University of Tokyo.
Int Heart J. 2023 Jul 29;64(4):768-774. doi: 10.1536/ihj.22-614. Epub 2023 Jul 14.
Cardiac resynchronization therapy (CRT) is a standard treatment for patients with severe congestive heart failure. However, one-third of patients receiving CRT are non-responders. Conduction system pacing (CSP), including His-bundle pacing (HBP) and left bundle branch area pacing (LBBAP), has become an alternative to CRT therapy. Furthermore, CRT therapy with CSP has shown to be more effective than CRT alone. When an implantable cardiac defibrillator or CRT-defibrillator is implanted with CSP, the problem of which port the HBP lead and LBBAP lead should be connected to arises. We report 2 cases of upgrading to CRT with CSP by utilizing the atrial ports for HBP and LBBAP leads. The procedure is a simple, reasonable, and effective therapy for end-stage heart failure.
心脏再同步治疗（CRT）是重度充血性心力衰竭患者的标准治疗方法。然而，接受CRT治疗的患者中有三分之一无反应。传导系统起搏（CSP），包括希氏束起搏（HBP）和左束支区域起搏（LBBAP），已成为CRT治疗的替代方法。此外，CSP联合CRT治疗已被证明比单纯CRT更有效。当植入式心脏除颤器或CRT-除颤器与CSP一起植入时，就会出现HBP导线和LBBAP导线应连接到哪个端口的问题。我们报告了2例通过利用心房端口连接HBP和LBBAP导线升级为CSP联合CRT的病例。该手术是一种针对终末期心力衰竭的简单、合理且有效的治疗方法。
