医学
QRS波群
心内注射
左束支阻滞
心脏病学
束支阻滞
内科学
心脏传导系统
外科
心电图
心力衰竭
作者
Ji-Ming Guo,Linlin Li,Guosheng Xiao,Xinyi Huang,Qiang Li,Yan Wang,Binni Cai
摘要
Abstract Background Left bundle branch pacing (LBBP) has emerged as a promising pacing modality for preventing pacing induced cardiomyopathy in patients complicated with conduction abnormalities (CAs) after prosthetic valve (PV) implantation. Objective The present study aimed to evaluate the safety and feasibility of LBBP in this patient population. Methods LBBP was attempted in 20 patients complicated with atrioventricular block after PV implantation. Surface, intracardiac electrical measurements, and echocardiographic data were documented. Lead parameters and complications were routinely tracked at implantation and each follow‐up visit. Results LBBP was successful in 90% (18/20) participants. The paced QRS duration and the stimulus to left ventricular activation time were 106.8 ± 6.8 ms and 65.5 ± 5.4 ms, respectively. Left bundle branch (LBB) potential was recorded in 61.1% (11/18) patients who succeeded in LBBP. During the procedure, the mean unipolar myocardium capture threshold was 0.51 ± 0.15 V@0.4 ms while the unipolar bundle capture threshold was 0.84 ± 0.51 V@0.4 ms. The mean fluoroscopic exposure time and the radiation dose were 13.0 ± 9.2 min and 81.7 ± 8.3 mGy, respectively. The average follow‐up period was 10.4 ± 5.9 months (range 3‐23 months). Pacing parameters remained stable and no significant lead‐related complications occurred during the whole observation period. Conclusions LBBP was safe and feasible in patients with PVs. Acceptable and stable pacing parameters could be expected during the procedure and the follow‐ups.
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