【摘要】 目的观察心室再同步化治疗的特殊病例处理。方法对2例扩张型心肌病因冠状静脉畸形、左心室起搏电极不能达到理想起搏位置的患者采用心外科微创手术植入左心室心外膜起搏电极。结果2例患者三腔起搏器各起搏电极植入过程顺利,起搏器工作良好,起搏心率为80次/min。左心室收缩同步性均较术前改善。术后1周心功能均恢复至NYHA心功能分级Ⅲ级。无并发症。结论对经导管径路植入左心室电极失败的患者应用微创开胸左心室心外膜起搏电极植入进行心脏再同步化治疗是可行、安全且有效的。更多还原

【Abstract】 Objective To observe management of special cases in cardiac resynchronization therapy. Methods Left ventricular(LV) epicardial electrodes were implanted by minimally invasive thoracotomy in two patients in whom LV electrodes could not been placed at ideal positions because of coronary vein malformation. Results All electrodes of three-chamber pacemaker were implanted successfully without any complication. Pacemaker worked well with pacing rate 80 beat per minute. Synchronization of LV contraction improved immediately and heart function recovered from NYHA IV to NYHA III one week after operation. Conclusion Epicardial electrode implanted by minithoracotomy after failed coronary sinus implantation is safe, effective and feasible in cardiac resynchronization therapy.更多还原