经冠状窦心室起搏替代传统右心室起搏的可行性与必要性研究

传统右心室心内膜起搏的电极必须跨过三尖瓣方可到达起搏靶点,存在诸多局限和弊端。该文综述了有关右心室起搏的实现方法及优缺点,如违反生理性激动顺序对QRS波及左心室电机械活动产生不利影响、增加三尖瓣反流风险,而且禁用于三尖瓣置换者等;冠状静脉系统的解剖特点、经冠状窦心室起搏的应用现状。探讨在普通心脏起搏器植入术中经冠状窦心室起搏替代传统右心室起搏的必要性及可行性,为心脏起搏技术的改进提供新的思路。

Study on The Feasibility and Necessity of Replacing the Traditional Right Ventricular Pacing by Coronary Sinus Pacing

The electrodes of traditional right ventricular endocardial pacing must get accross three tricuspid valve to reach the pacing target, which has many limitations and drawbacks. Here is to make a review of the method of right ventricular pacing and its pros and cons, such as the adverse effect caused by the violation of physiological activation sequence on QRS and left ventricular electromechanical activity, the rising risk of tricuspid regurgitation, and the inapplicability in tricuspid valve replacement, and so on;as well as the anatomical features of coronary venous system, the application of the coronary sinus ventricular pacing. The study on the necessity and feasibility of replacing the traditional right ventricular pacing in ordinary pacemaker implantation by coronary sinus pacing provides new ideas to the improvement of the cardiac pacing technology.