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希氏束起搏与右心室起搏的对比研究。

His bundle pacing versus right ventricular pacing: A comparative study.

机构信息

Department of Cardiology, The Affiliated Chuzhou Hospital of Anhui Medical University, Chuzhou, Anhui, China.

Department of Cardiology, The First Affiliated Hospital of Anhui Medical University, Hefei, Anhui, China.

出版信息

Technol Health Care. 2023;31(6):2125-2134. doi: 10.3233/THC-220746.

Abstract

BACKGROUND

Pacing is the most effective and dependable method for treating complete atrioventricular block (AVB).

OBJECTIVE

The purpose of this study is to investigate the use of His bundle pacing (HBP) in patients with atrioventricular block.

METHODS

Patients who underwent HBP or right ventricular pacing (RVP) were enrolled and divided into two groups: the HBP group and the RVP group, respectively. We compared baseline clinical data, fluoroscopy duration, operation duration, pacing electrode parameters during the operation or follow-up, baseline QRS duration, and pacing QRS duration.

RESULTS

HBP was attempted in 48 patients and was successful in 34 patients who were included in the HBP group. In addition, 30 RVP patients were included in the RVP group. Fluoroscopy duration and operation duration were significantly longer in the HBP group compared to the RVP group. Compared to the RVP group, the HBP group had a higher pacing threshold, a lower R wave amplitude, and a shorter pacing QRS duration. At 6 months of follow-up, the pacing threshold remained higher, the R wave amplitude was significantly lower, and the end-diastolic diameter of the left ventricle was smaller in the HBP group.

CONCLUSION

HBP was safe and effective for atrioventricular block despite the longer fluoroscopy and operation duration in the HBP group when compared to the RVP group.

摘要

背景

心脏起搏是治疗完全性房室传导阻滞(AVB)最有效和可靠的方法。

目的

本研究旨在探讨希氏束起搏(HBP)在房室传导阻滞患者中的应用。

方法

入选行 HBP 或右心室起搏(RVP)的患者,并分为 HBP 组和 RVP 组。比较两组患者的一般临床资料、透视时间、手术时间、术中或随访时的起搏电极参数、基础 QRS 时限和起搏 QRS 时限。

结果

共 48 例患者尝试行 HBP,其中 34 例成功纳入 HBP 组,同时纳入 30 例 RVP 患者作为 RVP 组。HBP 组的透视时间和手术时间明显长于 RVP 组。与 RVP 组相比,HBP 组的起搏阈值较高,R 波振幅较低,起搏 QRS 时限较短。在 6 个月的随访中,HBP 组的起搏阈值仍较高,R 波振幅显著降低,左心室舒张末期直径较小。

结论

与 RVP 组相比,HBP 组透视和手术时间较长,但 HBP 治疗房室传导阻滞安全有效。

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