左束支区域起搏的临床应用初探

The preliminary application of left bundle branch area pacing

目的:评价左束支区域起搏(left bundle branch area pacing,LBBP)的成功率、安全性及有效性。方法:LBBP组分为学习曲线初级阶段和基本掌握植入技术阶段。回顾性分析同期行LBBP和传统右室起搏(rapid ventricular pacing,RVP)的患者,比较两种不同起搏方式的手术成功率、手术用时、起搏的QRS波时限和其他起搏参数;进行随访,平均随访(6.78±2.80)个月,观察起搏参数的变化。结果:LBBP手术成功率在学习曲线初级阶段为55.6%,在基本掌握植入技术阶段为88.9%;两个阶段的起搏参数无明显差异(P> 0.05);LBBP组和RVP组的起搏阈值分别为(0.67±0.14)V和(0.77±0.23)V,LBBP组阈值更低(P <0.05),短期随访起搏参数稳定;两组起搏的QRS时限分别为(112.50±9.96)ms和(164.00±19.32)ms,LBBP组起搏的QRS时限更窄(P <0.05),短期观察无并发症发生。结论:LBBP具有良好可操作性,短期随访安全、有效。

Objective:This study aims to investigate the successful rate of the left bundle branch area pacing(LBBP),the safety and effectiveness of the technology.Methods:Thirty-six patients were divided into LBBP group and RV pacing group according to the position of the RV lead.The baseline characteristics,successful rate,procedure time,paced QRS duration and pacing parameters were investigated.Results:In the presence of accumulated of the experience,the successful rate increased up to 88.9%.The thresholds of the LBBP group were lower than those of RVP group((0.67±0.14)V vs.(0.77±0.23)V,P<0.05)The QRS duration of the LBBP group was narrower than that of RVP group((112.50±9.96)ms vs.(164.00±19.32)ms,P<0.05)The pacing parameters during the follow up appeared to be stable with no complication occurred.Conclusion:LBBP was safe and effective.