摘要
目的建立左束支传导阻滞(LBBB)犬模型,探讨左束支区域起搏(LBBAP)纠正LBBB的可行性及有效性。方法研究选取6只比格犬,雌雄各半,体重(17.7±1.4)kg,在X线影像及三维模型指导下,应用压力消融导管经主动脉逆行途径标测并消融左束支。成功建立LBBB模型后,在X线影像指导下进行LBBAP。分析LBBAP的起搏参数和左心室达峰时间,并比较LBBAP前后的QRS波形态和时限。结果6只犬均成功建立LBBB模型,其中5只犬成功进行LBBAP,1只犬因心室导线无法旋入室间隔致导线植入失败。LBBAP起搏阈值感知参数良好,LBBAP的左心室达峰时间明显缩短(48.2±2.5)ms,LBBAP前后QRS时限变化差异有统计学意义[(118.4±3.2)ms对(57.6±3.2)ms,(P<0.001)]。结论成功建立LBBB犬模型。LBBAP能够有效纠正LBBB,具有较高的可行性。
Objective To explore the feasibility and efficacy for left bundle branch area pacing(LBBAP)in left bundle branch block(LBBB)canine model.Methods A total of 6 canines of half male and half female,about(17.7±1.4)kg in weight,were included in our study.Using X-ray and 3-dimensional electroanatomic mapping system,the mapping and radiofrequency catheter ablation(RFCA)of left bundle branch were performed using contact force-sensing catheter via a retrograde aortic approach.After LBBB canine model was successfully established,LBBAP was conducted using X-ray imaging.The pacing parameters and stimulus to left ventricular activation time(S-LVAT)of LBBAP were analyzed,and QRS morphology and duration before and after LBBAP were recorded and compared.The successful LBBB-correction rate of LBBAP was also analyzed.Results LBBB model were successfully established in all the 6 canines.There were 5 of 6 canines underwent successful LBBAP,and the remaining 1 canine failed because the ventricular lead could not be screwed into the interventricular septum.The pacing and sensing parameters were fine.The mean S-LVAT of LBBAP was(48.2±2.5)ms,and the QRS duration before and after LBBAP were significantly different[(118.4±3.2)ms vs.(57.6±3.2)ms,P<0.001].Conclusion Our results suggest the LBBB canine model by RFCA of left bundle branch can be effectively corrected by LBBAP.
作者
蔡迟
华伟
黄灏
邓宇
程思静
牛红霞
刘曦
宁小晖
王靖
丁立刚
楚建民
张澍
Cai Chi;Hua Wei;Huang Hao;Deng Yu;Cheng Sijing;Niu Hongxia;Liu Xi;Ning Xiaohui;Wang Jing;Ding Ligang;Chu Jianmin;Zhang Shu(Center of Arrhythmia,Fuwai Hospital,State Key Laboratory of Cardiovascular Disease,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences,Peking Union Medical College,Beijing 100037,China)
出处
《中华心律失常学杂志》
2022年第6期572-577,共6页
Chinese Journal of Cardiac Arrhythmias
基金
国家自然科学基金(82070349)
中央高校基本科研业务费专项资金(3332020016)。
关键词
心脏起搏
人工
左束支传导阻滞
左束支区域起搏
射频导管消融
犬
Cardiac pacing,artificial
Left bundle branch block
Left bundle branch area pacing
Radiofrequency catheter ablation
Canine
