希氏束起搏在慢性心力衰竭患者中的应用

Application of His Bundle Pacing in Patients with Chronic Heart Failure

希氏束-浦肯野纤维是心脏传导系统的重要组成部分,希氏束起搏(HBP)是通过自身希氏束-浦肯野纤维系统传导,具有保留心脏机械同步性的优势,是目前最生理性的心脏起搏方式,可避免心室收缩的不同步,减少心力衰竭的发生。HBP分为选择性希氏束起搏和非选择性希氏束起搏。对于需要高比例心室起搏、右室起搏导致心功能恶化、因房颤合并心衰行房室结消融控制心室率以及部分符合CRT适应证的患者,希氏束起搏可显著改善心功能,本文就此进行阐述。

His bundle-Purkinje fiber is an important part of the heart conduction system. His bundle pacing (HBP) is transmitted through its own His bundle-Purkinje fiber system, which has the advantage of retaining the mechanical synchronism of the heart. The most physiological cardiac pacing method can avoid the ventricular contraction and reduce the occurrence of heart failure. HBP is divided into selective His bundle pacing and non-selective His bundle pacing. Histilb pacing can significantly improve cardiac function in patients requiring high-grade ventricular pacing, right ventricular pacing leading to deterioration of cardiac function, and atrioventricular node ablation to control ventricular rate due to atrial fibrillation and heart failure, and partial compliance with CRT indications. This article explains this.