左束支起搏治疗心力衰竭合并右束支传导阻滞一例报道

Left Bundle Branch Pacing in the Treatment of Heart Failure Complicated with Right Bundle Branch Block:a Case Report

心脏再同步化治疗(CRT)是心力衰竭伴宽QRS波群患者临床治疗的有效手段,但传统双心室起搏不能改善心力衰竭合并右束支传导阻滞(RBBB)患者的心功能,而希氏束起搏可纠正心力衰竭合并左束支传导阻滞(LBBB)和RBBB患者的心功能,但希氏束起搏阈值较高。本文报道1例中国人民解放军白求恩国际和平医院收治的心力衰竭合并RBBB患者,其在心脏再同步化治疗及埋藏式心脏自动除颤器植入术中采用左束支起搏(LBBP),术后患者心功能明显改善,这可能为LBBP在心力衰竭合并RBBB患者中的应用提供了参考。

Cardiac resynchronization therapy(CRT)is an effective means of clinical treatment for patients with heart failure and wide QRS complex.However,traditional biventricular pacing cannot improve the cardiac function of patients with heart failure combined with right bundle branch block(RBBB),while His bundle pacing can correct the cardiac function of patients with heart failure combined with left bundle branch block(LBBB)and RBBB,but the threshold of His bundle pacing is high.This paper reports a heart failure patient complicated with RBBB admitted to Normal Bethune International Peace Hospital of P.L.A.During the cardiac resynchronization therapy with implantable cardioversion defibrillator implantation surgery,left bundle branch pacing(LBBP)was used,which significantly improved the patient's cardiac function.This may provide a reference for the application of LBBP in heart failure patients complicated with RBBB.