经导管主动脉瓣置换术后左束支传导阻滞的研究进展

Research progress of left bundle branch block associated with transcatheter aortic valve replacement

左束支传导阻滞是经导管主动脉瓣置换术后最常见的传导障碍类型。术后新发持续性左束支传导阻滞可引起心室舒缩障碍,进展为高度房室传导阻滞时,常影响患者预后。永久起搏器植入术可作为经导管主动脉瓣置换术后新发持续性左束支传导阻滞的治疗方案,但其植入适应证尚需进一步临床论证。与左束支传导阻滞相关的传导系统起搏有望成为其主要治疗手段,但远期预后尚不明确。本文总结了经导管主动脉瓣置换术后左束支传导阻滞的相关因素、预后及治疗等方面的研究进展。

Left bundle branch block is the most common type of conduction disorder after transcatheter aortic valve replacement.Postoperative persistent left bundle branch block can cause ventricular systolic and diastolic dysfunction,which often affects the prognosis of patients when it progresses to high atrioventricular block.Permanent pacemaker implantation is often used as a new treatment for persistent left bundle branch block after transcatheter aortic valve replacement,but its indication needs further clinical demonstration.The pacing of the conduction system related to the left bundle branch block is the fundamental treatment,but the long-term prognosis is still unclear.This article summarized the research progress in the related factors,prognosis,and treatment of left bundle branch block after transcatheter aortic valve replacement.