肥厚型梗阻性心肌病化学消融术所致室内传导阻滞的临床特点

Clinical features of intraventricular conduction block after the alcohol septal in patients with hypertrophic obstructive cardiomyopathy

目的：研究肥厚型梗阻性心肌病（HOCM）患者给予经皮经腔间隔心肌化学消融术（PTSMA）治疗后室内传导阻滞的临床特点。方法选择2004年1月-2012年12月在辽宁省人民医院行PTSMA的HOCM患者200例为研究对象。监测PTSMA术中及术后患者12导联心电图的变化，分析出现的室内传导阻滞类型及特点。结果术中及术后共有100例患者新发室内传导阻滞。其中完全性右束支传导阻滞者共90例，30例（33.3%）是永久性束支传导阻滞；完全性左束支传导阻滞者10例，其中1例（10.0%）为永久性束支传导阻滞。结论 PTSMA术中及术后出现的室内传导阻滞中，易发生完全性右束支传导阻滞，并且传导系统恢复时间较长，不易发生完全性左束支传导阻滞，如果出现完全性左束支传导阻滞，也多为一过性，其传导系统可迅速恢复。

Objective To investigate the clinical features of intraventricular conduction block after the percutaneous transluminal septal myocardial ablation （PTSMA） in patients with hypertrophic obstructive cardiomyopathy （HOCM）. Meth-ods 200 patients with HOCM underwent PTSMA in Liaoning Provincial People＇s Hospital from January 2004 to De-cember 2012 were selected in this study. Twelve-lead electrocardiograms were obtained during and post PTSMA. The types and characteristics of the intraventricular conduction block were analyzed. Results Intraventricular conduction block was induced in 100 patients by PTSMA. Which appeared complete right bundle branch block in 90 patients, 30 cases （33.3%） had permanent block appeared. Intraoperative complete left bundle branch block in 10 patients, 1 case （10.0%） had permanent block appeared. Conclusion PTSMA of intraoperative and postoperative intraventricular con-duction block, the high incidence of complete right bundle branch block, and conduction system recovery time is longer; less prone to complete left bundle branch block, even if there is complete left bundle branch block is also a transient, conduction system can be quickly restored.