经冠状静脉植入左室心外膜电极实现不同类型起搏2例

Two cases of different pacing by implantation of left ventricular epicardial electrode via coronary vein

1病例资料例1,男,79岁,因"呼吸困难1周,伴黑朦3次"于2019年2月10日入院。20年前行二、三尖瓣膜置换术,规范口服地高辛、呋塞米、美托洛尔、华法林及沙库巴曲缬沙坦钠片等后疗效不佳。体表心电图(ECG)示:心房颤动伴三度房室传导阻滞(AVB),心室率33次/min,QRS 110ms;超声心动图(UCG):左室舒张末期内径(LVEDD)57mm,左室收缩末期内径(LVESD)42 mm。

In special cases, the left ventricular electrode lead can be connected to different pacing pulse generators. This way was a safe and feasible alternative approach for cardiac resynchronization therapy(CRT). Here, we reported two special cases with electrodes implanted via coronary vein. The first case was a single-chamber pacemaker which was consisted by the connection of the left ventricular electrode lead and the single-chamber pacing pulse generator. In case 2, the dual chamber pacemaker was formed by standard pacemaker but with left and right ventricle lead wires. We programmed the pacemaker to form biventricular pacing by making the AV interval of left ventricular ahead of right ventricular.The surgery was accomplished without severe complications. At follow-up, symptoms were alleviated, and quality of life was improved.