希浦系统起搏在CRT中的应用

Application of His-Purkinje system pacing in cardiac resynchronization therapy

1958年胸外科医生Senning为完全性房室传导阻滞患者植入了世界上首例埋藏式心脏起搏器,经过60余年的发展,从最初的右心室单腔起搏,到现在的双腔、三腔起搏,起搏器的风向标已经从单纯的激动心腔演变为追求电和机械同步性更佳的生理性起搏,应用范围也逐渐扩大,目前生理性起搏多采用希浦系统起搏。从最初的病态窦房结综合征、房室传导阻滞(atrioventricular block,AVB)等到现在的心脏再同步化治疗(cardiac resynchronization therapy,CRT),CRT可使用心脏再同步治疗起搏器(cardiac resynchronization therapy pacemaker,CRT-P)或心脏再同步治疗除颤器(cardiac resynchronization therapy defibrillator,CRT-D)。本文主要针对希浦系统起搏在CRT中的应用进行综述。

In 1958,Senning,a thoracic surgeon,implanted the world’s first buried pacemaker into a patient with complete atrioventricular block.After more than 60 years of development from the initial single chamber pacing of the right ventricle to the current dual chamber and three chamber pacing,the wind vane of the pacemaker has evolved from a simple exciting cardiac chamber to a physiological pacing pursuing better electrical and mechanical synchronization,The application scope is also gradually expanded.At present,His-purkinje system pacing is mostly used for physiological pacing.From the initial sick sinus syndrome and atrioventricular block(AVB)to the current cardiac resynchronization therapy(CRT),CRT can use cardiac resynchronization therapy pacemaker(CRT-P)or cardiac resynchronization therapy defibrillator(CRT-D).This paper mainly summarizes the application of His-purkinje system pacing in CRT.