左束支区域起搏术中室间隔心肌的损伤电流变化.docx
299必经合格!公。23年7名分39花第4WIC1.ina1.MZiCnwEchimiJnb2023.Vv1.39JSi储.左束支区域起搏术中室间隔心肌的损伤电流变化李靖茶如脸澄汹秋辞H佳中杨军江泰省无悔小第二人民医院心内科.½W2UOO2通信作品杨军.Emai1.:yangjunS211O2（KM11MH探讨左束支mfi1.UUcftbund1.ebranchn11mpacing.1.BBAP）木中生何隰心肌的损伤电源变化特点.方回顾性分析汀力行兄铅市3-2020年I月至2022年HJj行水久性起搪苑植入也者的临床资f1.M1.'b1.BBAr42M<1.nnAP用）.心空河内部起裨（rightVErkUur*cxum晔inf.RVSP,56例（RvSPW,比场再战I1.慑临入木'4常观警救W值.将刈和见批，由极掘U1.匍和到位后0.5.IOE.H蝌伤J'以"也仿电流：电垃认”相关性.计以资eQZrZJ料以x土»&示.两E间比设采用，松¥两缗/个时&仲1.<%）衣示,空间比较栗用X，除以：时关'。礼二氏电极植入术中起却网侦.您知和E巧比较楚片甘<：学。翎也IfiO.5.10Mn各时点缴饬K½fitJT.1<7.3.06>mV比（10.肪±1.70）m*i:5±2.63）mV'*±i.mV.两组豫并电微倒也后Omm崩.电/r均£于电极WH1.f到位ISKImin损伤电流值仍高于«沐、,（均PeQ±.M的方*分析：卜散筋科以例、析'总»两维SJ4BBaK6*出前和,(U±0.79)m'225O4*20mV比(f51±0.98)均RHU3A健I电极而SP理孑也外“出东平比我董H元物H学立式P>0.05>.1.BBAP?,UWyJn.堪。i1.，"，J中",隔1"/.：£后甲N展均三*<r值分别为0.45利0.46.P'分别：0。3和U.怖常规夕“<欣阻'.电负相关”=O.32.P=O.O37）,与阀仇和小知未见相.人和rf>二二8NaC”“去别，.604和0.»68）.RVSM1.也掇到也用Omin姆饬电液做与阂仇,鱼相关（r=u.'g="3o）.1.BHAP宗何*心肌此物也流"M：电极杭H；1.；“,开开高.电极到位MUnun伙1嬴“KU1.隔"度.左心生后重度均某正相关,与电极用抗¥.负相关.而与闽价*述知未见相关关系.【关901左束支区域起搏；惯伤电瓶：仃心生间隔部起抻；空间随心机Changekofvn1.ricubr%vpta1.myocurdiii1.injuncurrentinIcRbund1.ebraocharvupucis1.iJf”.Q加Xian.EmCheMFeRQk(ing.C(MJkmn.YangJttn/rrnfCardiogy.ihf5<vvtJP<v>p<vM><WmWiaiCiryinJianRWProv(,Wu11214002.ChifWCWrUWWn*Yon*Jurt.EnWihw“N*2H<)2126.cIw1.IAbs1.ractJObkaNeExp1.oretheChtfaaCfi5crofinjuryWfrenIGangesinvcmricuUrWpta1.mxnrdiumduring1.eftbux1.kbranchrcnPnCin1.I(1.RRAPK1.I里CryMHhfKkRemM<aivuana1.ysisofdinica1.IiMUofpuiicniswhoUndCrWeIHpcrnuctpaccnukcrm1.antanatTheSecondPCCPICKHospiu1.ofWUAiinJiUngH1.ProvincefromJanuary2020ioNovember2O22.AmongIkmd2IXUiE»wereIrVUkdWi1.h1.BBAP<1.BBAPgn>u>snd56xuen1.sWiuIRightventric1.eMrpCumacwgIRVSPg,rcup).C<>mpretheCenyCntkHU1.parume<crsucha%threj>W.pcrccp<i<Mi.impedan:durineCkUrodeimp1.antatiim.danugccurrentvaheat0.5.and10minutesbcf<xvandaftere1.cct11x3cntatkn.nndIhCc<Mcktinbcwcendnm£ccurrcnandcwvcn<irm111.呷AgGThCmcA*urvmcncUuRIM)I:IO376IO1.72120230207O(XM)26ttHBM2013024)7CftNM代小弟引用和匕李靖，泰娴，险澄，等左东支区域起携术中室间阳心肌的损伤电流变化小中国媒台临床.202.39(4k299.3(B.DOI:10376a'c11ajxnIO1.72120230207<)00026.9中国汉介临!K2023年7月第39t¾4UimMww"ChmuJ出2O23VEWN'.4representedbyx±skana1.ysisofvarianceusedtorcomparisonbetweenmu1.tip1.egrops.-tcisusedforCotiYpctfisonHeiwveniwog(oups.andrepeatedn心SItfememau1.ysvofvarianceisusedforOompa1.iSOnKe1.wecnIwogn11psatmuhipk1.imepc>inK;Countingdatai、rvpnsM11He1.asanexamp1.e(%).andintergroupcomparisonsarcmadeusingXjInspcctionJjCarsoncorre1.ationana1.ysiswasusedtoana1.yzetheCiimIa1.KMibetween(heIwuVari;IbkKReM1.1.NTherVW弊noNU1.IiNt:W1.yXiP1.iiiCan1.differenceinPUCingthresho1.d,perceptionkandimpedancebetweenthewogroupsofCkX1.rodCimp1.antationsrgcr>(a1.1.P>0.05).ThedamageOnTeIUva1.uesa1.0.5,andiminutesbefcJindaftere1.ectrodeatkx)inhe1.BBAPgrupwerehigherth*nIhCKCintheRVSPgroup(7.1.9±1.,26)mVCQnIParCdto(5.33±O.79)mV22.5Ot3.06)mVcomparedto(10.85±1.70>mV.(15.752.63)mVcomparedco(8.01±1.09)<nV,(9.2412.)mVCiHnpiinx1.(5.51±0.98)mV11wdamageCUnVnIva1.ue、a1.Ominutesa!krekctn1.e111.h11ninb<Hhgroupswetvhigher(hanbeforee1.ectroder0<at>on1.gradua1.1.ydecreased(hcrcafrftcrIOminutcsofekcuodebcen½n.thedamgecuretva1.ueOfIbeI-BBAPgroupWaSMi1.1.hig1.½rdunthekvv1.bet<weC1.ErOdCr1.ation(a1.1.P<0.()5).whi1.ebcrrwasnoS1.atiMka1.Iysignifkanidit1.crmccMIWcCn(beRVSPgroupand!eIeVeIbeforee1.ecu<x1.ervati(x)<P><).05).TIedamageCUnVIUva1.uea1.Ominuterafterthe1.BBAPgroupC1.ErOdCwasinp1.acewaspositive1.yCOnriaIG1.,thVCntriCUIarSCPtUJthicknessandkftVCntjkUIarPOsIeriorwa1.1.IhiCknE(rva1.ues0.45and'va1.uesv.andO.OOZgApccHvC1.y)faDdnegative1.ycorre1.atedwithconventiona1.PaCmgPPJnetCrininee尸'2P=0.037).Therewas>CVHiv1.aiionwithIhreihoIdandPetvVPti<rv°,O.阴and0.1.va1.uesC6KJI0.968.rspcctiveiykI1.iediirnagecurrentva1.ue;i1.Ominute*.erIhcY?g11xpekc1.r<k.inp”、waxnega1.ivdyCiHTC1.a1.edwiththeIhrtsbok1.(r=0.284).(36>.('ondu%.septumm>,ocardiumi11acascdsigrKam1.-erIhr八CCtr(XkaftertheC1.CCtnxkputinp1.acewa1xwidvccoIatedwith/1.eftventricu1.arposteriorWaH(hid.ess,andiw»,yc<irre,*wasm>CCMTvIadnnWiu1.(Ire411k1.:dpervetx(Keywords1.eftbmcbranchareaPaCing:«Stfp1.mnxingVentricukrep!a1.ny<r.hu起耨电极囿定在心内膜心肌在个之内电产匕可产生急性损伤型改变，表现为S.段的1及时程的延长,称为扭伤电流.传统起入电极固加”'中,相伤电汨足除希般起搏畲故阈值、5>.队抗外的另客戏指标,有助判断电极是否粒定.左束太区域起搏(他仰bur1.1.ebranchnrap;HriI1.gJ.BHAPj是一种新兴的生理性起搏方式，通过将电极8找从灯心空穿间1.深拧到达左心空间1.面内媵下的左束支区域，使电液功能迅速扩布至左傅传导系统，实现左心室电学同步2,包括左束支起搏和左心室向隔面起裨有研究表明左束支起抻过程中常产生左束支的损伤电流.记录到左束支电位预示皆相对低的选择性有来阈值，倒并不是所有忠者均能记双到'向1.BBAP过程中关于室间为心肌投仿电流的研究较少.本研究H在探讨1.BBAP与传统右心室间隔ffihiM(11gh1.ventricu1.arSeP1.UmPaCingNVSP)空间能心肌捡伤电流的变化特点，责科与方法一、一般资料I可«!性分析江芳省无砌山.第二人民医院XmViiIiieof1.BBAIIenen1.ricukrIhr<XtcdOUtTb.)1V,a1.Omin,IicncntricrhrZm1.hkncssandwu>t!ce1.ectXJeineda>.buhet,cuofirjr)Rhtcntricu1.arj年IrZ2。'，年11月行永久性起搏Z植入患齐的丫口：Ho4Jjf1.BBAP42例
