双房三腔心脏起搏治疗慢-快综合征

Treatment of Trady-bachycardia syndrome by bi-atrial synchronic tri-chamber pacing

目的 为治疗病窦综合征并快速性房性心律失常（ 慢－ 快综合征） ，予患者植入三腔（ 双房同步） 心脏起搏器。方法 经左锁骨下静脉穿刺，依次植入冠状静脉窦、右心室、右心房起搏电极导线，经测试各参数满意后，经Ｙ 型转接器将冠状静脉窦电极与右心房电极组成新的心房双极电极。植入后分别进行ＤＤＤ 和双房ＡＡＴ 起搏。结果 随访３ 个月，患者症状完全缓解，心律失常消失，未出现并发症。证明三腔心脏起搏器不仅能治疗缓慢性心律失常而且能有效地防治因房间传导阻滞引起的快速性房性心律失常，该型起搏器植入术有一定的技术难度，但合并症少、安全、具有一定的治疗效果。

Objective\ To treat sick sinus syndrome with paroxysmal atrial tachy-arrhythmias (brady-tachycardia syndrome),tri-chamber pacemaker with bi-atrial synchrony were implanted.Methods\ Three leads were inserted into the coronary sinus (CS),right,ventricle (RV) and right auricle (RA) respectively via the left subclavian.CS lead and RA lead consisted of a new bi-atrial lead through a 'y\' shape adapter after pacing parameter test.DDD pacing and bi-atrial AAT pacing mode were used respectively.Results\ Patient was followed up to 3 months,atrial tachy-arrhythmias disappeared and symptoms were alleviated completely without any complication.Conclusion\ Our study demonstrated that tri-chamber bi-atrial snchronized pacing can not only treat bradyarrhythmias but also effectively prevent atrial tachyarrhythmias caused by intra-atrial conduction block.it is safe and has less complications in spite of some difficult implanting techniques.