左束支起搏在儿童心血管疾病中的应用及展望

doi:10.12372/jcp.2022.21e1257

摘要/Abstract

摘要：

希氏束区域起搏是生理性的心室起搏方式,能够实现电再同步并使双室同步激动。而左束支起搏(LBBP)弥补了希氏束区域起搏（HBP）的不足,操作简单,起搏参数更优。但LBBP在儿童心血管疾病中应用的可行性和安全性尚未得到广泛验证,同时儿童生理特点、心脏结构等与成人的差别意味着LBBP在儿童的应用需要作一定调整。文章从左束支起搏的发展历程,左束支起搏的优势、左束支起搏在儿科的应用以及调整进行综述,以探究左束支起搏在儿童心血管疾病中的应用和发展前景。

关键词: 生理起搏, 希氏束区域起搏, 左束支起搏, 房室传导阻滞, 左束支传导阻滞

Abstract:

His bundle pacing (HBP) is a physiological pacing mode of ventricular pacing, which can promote electrical resynchronization and biventricular synchrony. The left bundle branch pacing (LBBP), which was a supplement to HBP, has the advantages of simple operation and better parameters. However, the feasibility and safety of LBBP in children have not been well verified. And the differences in physiological characteristics and heart structure between children and adults are different which mean that the application of LBBP in children needs to be adjusted. In this review, we attempt to discuss the development of LBBP, the advantages of LBBP, the application and adjustment of LBBP in pediatrics, in order to explore the application and prospect of LBBP in children with cardiovascular diseases.

Key words: physiological pacing, his bundle pacing, left branch bundle pacing, atrioventricular block, left bundle branch block

熊淼, 吕铁伟. 左束支起搏在儿童心血管疾病中的应用及展望[J]. 临床儿科杂志, 2022, 40(4): 316-320.

XIONG Miao, LYU Tiewei. Application and prospect of left bundle branch pacing in children with cardiovascular diseases[J]. Journal of Clinical Pediatrics, 2022, 40(4): 316-320.

参考文献 31

[1]	Brignole M, Auricchio A, Baron-Esquivias G, et al. 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA)[J]. Eur Heart J, 2013, 34(29):2281-2329. doi: 10.1093/eurheartj/eht150 pmid: 23801822
[2]	Karpawich PP, Rabah R, Haas JE. Altered cardiac histology following apical right ventricular pacing in patients with congenital atrioventricular block[J]. Pacing Clin Electrophysiol, 1999, 22(9):1372-1377. doi: 10.1111/pace.1999.22.issue-9
[3]	van Oosterhout MF, Prinzen FW, Arts T, et al. Asynchronous electrical activation induces asymmetrical hypertrophy of the left ventricular wall[J]. Circulation, 1998, 98(6):588-595. doi: 10.1161/01.cir.98.6.588 pmid: 9714117
[4]	Lee MA, Dae MW, Langberg JJ, et al. Effects of long-term right ventricular apical pacing on left ventricular perfusion, innervation, function and histology[J]. J Am Coll Cardiol, 1994, 24(1):225-232. pmid: 8006270
[5]	Little WC, Reeves RC, Arciniegas J, et al. Mechanism of abnormal interventricular septal motion during delayed left ventricular activation[J]. Circulation, 1982, 65(7):1486-1491. pmid: 7074805
[6]	Sweeney MO, Hellkamp AS, Ellenbogen KA, et al. Adverse effect of ventricular pacing on heart failure and atrial fibrillation among patients with normal baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction[J]. Circulation, 2003, 107(23):2932-2937. doi: 10.1161/01.CIR.0000072769.17295.B1
[7]	Dandamudi G, Vijayaraman P. How to perform permanent His bundle pacing in routine clinical practice[J]. Heart Rhythm, 2016, 13(6):1362-1366. doi: 10.1016/j.hrthm.2016.03.040 pmid: 27016475
[8]	Deshmukh P, Casavant DA, Romanyshyn M, et al. Permanent, direct His-bundle pacing: a novel approach to cardiac pacing in patients with normal His-Purkinje activation[J]. Circulation, 2000, 101(8):869-877. pmid: 10694526
[9]	Vijayaraman P, Naperkowski A, Subzposh FA, et al. Permanent His-bundle pacing: long-term lead performance and clinical outcomes[J]. Heart Rhythm, 2018, 15(5):696-702. doi: 10.1016/j.hrthm.2017.12.022
[10]	Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society[J]. Circulation, 2019, 140(8): e 382-e482.
[11]	Chan J, Huang WJ, Yan B. Non-invasive electro-cardiographic imaging of His-bundle and peri-left bundle pacing in left bundle branch block[J]. Europace, 2019, 21(6):837. doi: 10.1093/europace/euy293
[12]	Sharma PS, Dandamudi G, Naperkowski A, et al. Permanent His-bundle pacing is feasible, safe, and superior to right ventricular pacing in routine clinical practice[J]. Heart Rhythm, 2015, 12(2):305-312. doi: 10.1016/j.hrthm.2014.10.021
[13]	Ajijola OA, Upadhyay GA, Macias C, et al. Permanent His-bundle pacing for cardiac resynchronization therapy: Initial feasibility study in lieu of left ventricular lead[J]. Heart Rhythm, 2017, 14(9):1353-1361. doi: 10.1016/j.hrthm.2017.04.003
[14]	Sharma PS, Dandamudi G, Herweg B, et al. Permanent His-bundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy: A multicenter experience[J]. Heart Rhythm, 2018, 15(3):413-420. doi: 10.1016/j.hrthm.2017.10.014
[15]	Vijayaraman P, Chung MK, Dandamudi G, et al. His bundle pacing[J]. J Am Coll Cardiol, 2018, 72(8):927-947. doi: 10.1016/j.jacc.2018.06.017
[16]	Huang W, Su L, Wu S, et al. Long-term outcomes of His bundle pacing in patients with heart failure with left bundle branch block[J]. Heart, 2019, 105(2):137-143. doi: 10.1136/heartjnl-2018-313415
[17]	Wu S, Su L, Wang S, et al. Peri-left bundle branch pacing in a patient with right ventricular pacing-induced cardiomyopathy and atrioventricular infra-Hisian block[J]. Europace, 2019, 21(7):1038. doi: 10.1093/europace/euz031
[18]	Lustgarten DL, Crespo EM, Arkhipova-Jenkins I, et al. His-bundle pacing versus biventricular pacing in cardiac resynchronization therapy patients: A crossover design comparison[J]. Heart Rhythm, 2015, 12(7):1548-1557. doi: 10.1016/j.hrthm.2015.03.048 pmid: 25828601
[19]	Abdelrahman M, Subzposh FA, Beer D, et al. Clinical outcomes of his bundle pacing compared to right ventricular pacing[J]. J Am Coll Cardiol, 2018, 71(20):2319-2330. doi: S0735-1097(18)33478-8 pmid: 29535066
[20]	Huang W, Su L, Wu S, et al. A novel pacing strategy with low and stable output: pacing the left bundle branch immediately beyond the conduction block[J]. Can J Cardiol, 2017, 33(12):1731-1736.
[21]	Chen K, Li Y, Dai Y, et al. Comparison of electrocardiogram characteristics and pacing parameters between left bundle branch pacing and right ventricular pacing in patients receiving pacemaker therapy[J]. Europace, 2019, 21(4):673-680. doi: 10.1093/europace/euy252
[22]	Vijayaraman P, Huang W. Atrioventricular block at the distal His bundle: electrophysiological insights from left bundle branch pacing[J]. HeartRhythm Case Rep, 2019, 5(4):233-236.
[23]	Huang W, Chen X, Su L, et al. A beginner’s guide to permanent left bundle branch pacing[J]. Heart Rhythm, 2019, 16(12):1791-1796. doi: 10.1016/j.hrthm.2019.06.016
[24]	Chen X, Jin Q, Li B, et al. Electrophysiological parameters and anatomical evaluation of left bundle branch pacing in an in vivo canine model[J]. J Cardiovasc Electrophysiol, 2020, 31(1):214-219. doi: 10.1111/jce.v31.1
[25]	Chen X, Wu S, Su L, et al. The characteristics of the electrocardiogram and the intracardiac electrogram in left bundle branch pacing[J]. J Cardiovasc Electrophysiol, 2019, 30(7):1096-1101.
[26]	Zhang L, Cheng X, Chen J, et al. Left Bundle pacing for left bundle branch block and intermittent third-degree atrioventricular block in a MYH7 mutation-related hypertrophic cardiomyopathy with restrictive phenotype in a child[J]. Front Pediatr, 2020, 8:312. doi: 10.3389/fped.2020.00312
[27]	Perin F, Molina-Lerma M, Jiménez-Jáimez J, et al. Combined use of subcutaneous implantable defibrillator with endovenous left bundle branch pacing in a child with hypertrophic cardiomyopathy[J]. Rev Esp Cardiol (Engl Ed), 2021, 74(3):265-267. doi: 10.1016/j.recesp.2020.06.039
[28]	易宏伟, 刘心甜, 韩宏伟. 小儿三度房室传导阻滞伴左心室扩大行左束支起搏一例[J]. 中华心律失常学杂志, 2020, 24(3):327-328.
[29]	Huang J, Zhou R, Pan Y, et al. Permanent left bundle branch area pacing in a child with a third-degree atrioventricular block: A case report[J]. J Cardiovasc Electrophysiol, 2020, 31(6):1539-1543. doi: 10.1111/jce.v31.6
[30]	Ji W, Chen X, Shen J, et al. Left bundle branch pacing improved heart function in a 10-year-old child after a 3-month follow-up[J]. Europace, 2020, 22(8):1234-1239. doi: 10.1093/europace/euaa090
[31]	赵辉, 王波, 王莹惠, 等. 主动固定电极3830与传统主动电极的比较研究[J]. 心脏杂志, 2017, 29(2):176-179.