心脏再同步化治疗左室电极导线的理想起搏部位及其个体化定位植入方法

左室电极导线的起搏部位是影响心脏再同步化治疗疗效的重要因素。多项临床研究表明左室电极导线的理想起搏部位是左室最延迟的机械收缩部位并且要避开心尖及疤痕区域。心脏再同步化治疗术前个体化确定最延迟机械收缩部位的方法有多种，但是存在心脏再同步化治疗术前确定的理想部位与心脏再同步化治疗术中经冠状静脉窦及分支造影确定的可植入左室电极导线血管分支不匹配的问题，因而对这部分患者失去了左室电极导线植入的指导意义。电生理标测冠状静脉窦分支最延迟电激动处靶向植入左室导线的心脏再同步化治疗可能是临床一种简便、实用、有效的方法。

Optimal Pacemaker Position of Left Ventricular Lead and Its Method of Individualized Placement in Cardiac Resynchronization Therapy

The pacing position of left ventricular lead is the important factors that affect cardiac resynchronization therapy impact. Many clinical studies have shown that the optimal left ventricular lead pacing position is the most delay of left ventricular contraction of me chanical parts and to avoid the apex and the scar area. There are many methods that cardiac resynchronization therapy preoperative individual determine the delay mechanical contraction area, but there are cardiac resynchronization therapy in preoperative definite optimal place and cardiac resynehronization therapy, coronary sinus and implantable left ventrieular lead vascular branch of branch screening to determine mis match problem, and thus lose left ventricular lead in this part of the patients implanted guiding significance. Electrophysiologieal standard to measure the coronary sinus branch at the delay electric excited point target into left ventricular lead cardiac resynchronization therapy may be a simple, practical and effective method for clinic.