Recovery of Right Ventricular Apical Pacing-Induced Cardiomyopathy with Left Bundle Branch Pacing.

Mert Doğan, Uğur Canpolat
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Abstract

Right ventricular pacing (RVP) is conventionally preferred in the treatment of patients with atrioventricular block. However, long-term RVP may lead to pacing-induced cardiomyopathy (PICM), characterized by new-onset or worsening ventricular functions due to dyssynchronous ventricular electrical activation, abnormal ventricular remodeling, and increased energy expenditure. Historically, biventricular pacing (BVP) and guideline-directed medical therapy were the only treatment option for PICM. Recently, conduction system pacing, including left bundle branch area pacing (LBBaP), has emerged as a physiological alternative to BVP, showing better results in electro-mechanical ventricular synchronization and hemodynamic parameters compared to BVP. We present a case involving a patient from whom the PICM was successfully recovered shortly after LBBaP.

用左束支起搏恢复右室心尖起搏诱发的心肌病
传统上,右室起搏(RVP)是治疗房室传导阻滞患者的首选方法。然而,长期右心室起搏可能会导致起搏诱发心肌病(PICM),其特点是由于心室电激活不同步、心室重塑异常和能量消耗增加而导致新发或恶化的心室功能。一直以来,双心室起搏(BVP)和指南指导下的药物治疗是治疗 PICM 的唯一选择。最近,包括左束支区起搏(LBBaP)在内的传导系统起搏已成为双心室起搏的生理学替代方案,与双心室起搏相比,它在电子机械心室同步和血流动力学参数方面显示出更好的效果。我们介绍了一例患者的病例,该患者在 LBBaP 术后不久成功恢复了 PICM。
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