Huang Keqiang, Gan Hongmei, Jiang Jingjing, Tang Cheng
Department of Cardiology, Wuhan Asia General Hospital, Wuhan, Hubei, China.
Front Cardiovasc Med. 2024 Jul 26;11:1391047. doi: 10.3389/fcvm.2024.1391047. eCollection 2024.
Left bundle branch pacing (LBBP) has proven to be an alternative method for delivering physiological pacing to achieve electrical synchrony of the left ventricle (LV), especially in patients with atrioventricular block and left bundle branch block (LBBB). However, it is unclear whether it still achieved in patients whose left bundle branch (LBB) has had surgery-induced damage. The Morrow operation (Morrow septal myectomy) is regarded as one of the most effective treatments for hypertrophic obstructive cardiomyopathy (HOCM). The surgery resects small sections of muscle tissue in the proximal ventricular septum nearby or contains the LBB, which means that physical damage to the LBB is almost inevitable. Approximately 2%-12% of patients may need pacemaker implanted after Morrow surgery. LBBP is a feasible and effective method for achieving electric resynchronization of LBBB compared to right ventricular pacing (RVB). Nevertheless, there is a dearth of data on LBBP in third-degree atrioventricular block (AVB) following Morrow surgery. We report a case of successful LBBP in those patients.
左束支起搏（LBBP）已被证明是一种实现生理性起搏以达到左心室（LV）电同步的替代方法，尤其是在患有房室传导阻滞和左束支传导阻滞（LBBB）的患者中。然而，对于左束支（LBB）遭受手术损伤的患者，LBBP是否仍能实现电同步尚不清楚。Morrow手术（Morrow室间隔心肌切除术）被认为是肥厚性梗阻性心肌病（HOCM）最有效的治疗方法之一。该手术切除靠近LBB或包含LBB的室间隔近端的小块肌肉组织，这意味着LBB几乎不可避免地会受到物理损伤。大约2%-12%的患者在Morrow手术后可能需要植入起搏器。与右心室起搏（RVB）相比，LBBP是实现LBBB电再同步的一种可行且有效的方法。然而，关于Morrow手术后三度房室传导阻滞（AVB）患者LBBP的数据却很匮乏。我们报告了一例在这些患者中成功进行LBBP的病例。
