先天性心脏病患者的传导系统起搏：早期经验

IF 2.2 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Archives of Cardiovascular Diseases Pub Date : 2025-09-01 DOI:10.1016/j.acvd.2025.06.008

Nathan Marimpouy , Stefano Bartoletti , Miarisoa Ratsimandresy , Reaksmei Ly , Clement Karsenty , Stéphane Combes , Nicolas Combes

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引用次数: 0

摘要

传导系统起搏（CSP）与他的束或左束分支刺激是一种有吸引力的新兴起搏模式，与一般人群更好的血流动力学结果相关。在先天性心脏病（CHD）方面的初步数据令人鼓舞。方法前瞻性评价CSP治疗伴有心室起搏的连续性冠心病的可行性、安全性和有效性。结果2022年1月至2024年12月，14例冠心病患者行起搏：房室管缺损（3例）、房间隔缺损（2例）、法洛四联症（2例）、TGA合并试验开关（2例）、ccTGA（1例）、先天性主动脉瓣狭窄（3例）、Ebstein异常（1例）。心室刺激的适应症是：完全房室传导阻滞(6)，室上性心动过速束消融(3)，起搏导联功能障碍(3)，心室再同步化(2)。平均随访11±8个月。CSP达到100%，起搏参数良好，1例急性并发症（局部血肿）。起搏后全身射血分数稳定的6例（42%），升高的8例（56%）。结论csp在绝大多数伴有腔内心室通路的冠心病患者中是可行的。它避免了心室起搏对血流动力学的不利影响，并具有心室再同步与血流动力学增加的潜在影响。有心室起搏指征的冠心病患者应给予CSP。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Conduction System Pacing in Congenital Heart Disease patients: Early experience

Introduction

Conduction System Pacing (CSP) with his bundle or left bundle branch stimulation is an attractive emerging pacing mode associated with better haemodynamic outcomes in general population. Preliminary datas are encouraging in congenital heart disease (CHD).

Method

In this study with prospectively evaluate feasibility, safety and efficacy of CSP in consecutive CHD with indication of ventricular pacing.

Results

Between January 2022 and December 2024, 14 CHD were referred for pacing: atrioventricular canal defect (3), atrial septal defect (2), tetralogy of Fallot (2), TGA with a trial switch (2), ccTGA (1), congenital aortic stenosis (3), Ebstein anomaly (1). Indications for ventricular stimulation were: complete AV block (6), his bundle ablation for supraventricular tachycardias (3), pacing lead dysfunction (3), ventricular resynchronization (2). Mean follow-up was 11 ± 8 months. CSP was achieved in 100% with good pacing parameters, with 1 acute complication (local haematoma). Systemic ejection fraction after pacing was stable in 6 (42%), increased in 8 (56%).

Conclusion

CSP in feasible in a was majority of CHD with endocavitary ventricular access. It avoids adverse haemodynamic effect of ventricular pacing with a potential effect of ventricular resynchronization with increase haemodynamics. CSP should by offered in CHD patients with indication for ventricular pacing.

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来源期刊

Archives of Cardiovascular Diseases 医学-心血管系统

CiteScore

4.40

自引率

6.70%

发文量

审稿时长

34 days

期刊介绍： The Journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles and editorials. Topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.