陈学智,董建增

• 1:北京大学国际医院心内科
• 2:首都医科大学附属北京安贞医院心内科

摘要(Abstract)：

传统右心室起搏（RVP）技术可引起三尖瓣反流、起搏器综合征等问题，理论上同步化更优的希浦氏系统起搏（HPBP）包括希氏束起搏（HBP）及左束支起搏（LBBP）可克服上述不足。HBP作为生理性起搏的代表，对左心功能及预后的良性作用已得到公认。少许研究显示HBP对右心功能有改善作用，但存在植入困难、远期阈值高等问题。LBBP作为HBP简易实用的替代技术，理论上的电-机械不同步会导致右心室功能受损，另外，LBBP电极跨越三尖瓣所致的机械性障碍也可能是导致右心室功能不良的因素。目前初步证据显示，HPBP中电-机械同步因素在右心功能中扮演更关键的角色，但对于LBBP而言缺乏足够的证据支持且机制不明。总之，目前HPBP对右心功能的影响研究不足，右心功能的无创评价指标也缺乏简易通用的单一金标准。新兴的双束支起搏（BBBP）技术可能同时避免HBP技术难度和LBBP不同步的缺点，但对右心功能的影响也需要进一步评价。

关键词(KeyWords)： 希浦氏系统起搏;左束支起搏;右心功能

Abstract:

Keywords:

基金项目(Foundation):

作者(Author): 陈学智,董建增

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