Higuchi Motoaki, Hasegawa Tomoaki, Chiba Yoshiro
Cardiology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan
Cardiology, Mito Saiseikai General Hospital, Mito, Ibaraki, Japan.
BMJ Case Rep. 2022 Aug 5;15(8):e248394. doi: 10.1136/bcr-2021-248394.
Cardiac resynchronisation therapy (CRT) for atrial fibrillation (AF) with intraventricular conduction and low cardiac output may not allow high-frequency biventricular pacing (BiVP). To this end, drugs and ablation treatments are commonly used. Ventricular sense response pacing (VSRP) senses self-pulse and can produce a state comparable with BiVP. If found to be effective for cardiac resynchronisation, the benefit of CRT with VSRP is expected to extend to patients with AF. Herein, we describe the case of a man in his early 60s with low cardiac output caused by AF and left bundle branch block. CRT-defibrillator (CRT-D) implantation was performed, and VSRP was applied. We found VSRP to be more effective in improving cardiac function than drug-induced BiVP. VSRP may become an effective treatment option following CRT-D implantation in patients with AF.
对于伴有室内传导阻滞和低心输出量的心房颤动（AF）患者，心脏再同步治疗（CRT）可能无法实现高频双心室起搏（BiVP）。为此，药物和消融治疗是常用的方法。心室感知反应起搏（VSRP）可感知自身脉搏，并能产生与BiVP相当的状态。如果发现VSRP对心脏再同步有效，那么CRT联合VSRP的益处有望扩展至AF患者。在此，我们描述了一名60岁出头因AF和左束支传导阻滞导致低心输出量男性的病例。进行了CRT除颤器（CRT-D）植入，并应用了VSRP。我们发现VSRP在改善心脏功能方面比药物诱导的BiVP更有效。VSRP可能成为AF患者植入CRT-D后的一种有效治疗选择。
