Retrospective analysis of CCTGA patients who underwent 3D-EAM-guided LVCSP. Three-dimensional-pacing map guided lead implantation towards septal sites with narrower paced QRS. Electrocardiograms (ECGs), echocardiograms, and lead parameters (threshold, sensing, and impedance) were compared at baseline (pre-implantation) and at 1-year follow-up. Right ventricle function was evaluated by 3D ejection fraction (EF), fractional area change (FAC), RV global longitudinal strain (GLS). Data are reported as median (25th-75th centiles). Seven CCTGA patients aged 15 (9-17) years, with complete/advanced AVB (4 with prior epicardial pacing), underwent 3D-guided LVCSP (5 DDD, 2 VVIR). Baseline echocardiographic parameters were impaired in most patients. No acute/chronic complications occurred. Ventricular pacing was >90%. At 1-year follow-up QRS duration showed no significant changes compared with baseline; however, QRS duration shortened in comparison with prior epicardial pacing. Lead parameters remained acceptable despite ventricular threshold increased. Systemic RV function was preserved: FAC and GLS improved significantly, and all patients showed normal RV EF (>45%).
Three-dimensional-EAM-guided LVCSP preserved RV systolic function in paediatric patients with CCTGA and AVB after short-term follow-up.
结果:对接受3D-EAM引导的LVCSP的CCTGA患者进行回顾性分析。三维起搏图引导导联植入至间隔部位,QRS波起搏较窄。心电图(ECG),超声心动图,和导线参数(阈值,传感,和阻抗)在基线(植入前)和1年随访时进行比较。通过3D射血分数(EF)评估右心室功能,分数面积变化(FAC),RV全局纵向应变(GLS)。数据报告为中位数(25-75百分位数)。7名15岁(9-17岁)的CCTGA患者,完整/高级AVB(4例先前心外膜起搏),接受3D引导LVCSP(5DDD,2VVIR)。大多数患者的基线超声心动图参数受损。无急性/慢性并发症发生。心室起搏>90%。在1年随访时,QRS持续时间与基线相比无显著变化;然而,与先前的心外膜起搏相比,QRS持续时间缩短。尽管心室阈值增加,但导线参数仍可接受。系统性RV功能得到保留:FAC和GLS明显改善,所有患者的RVEF均正常(>45%)。
结论:三维EAM引导的LVCSP可在短期随访后保留儿童CCTGA和AVB患者的RV收缩功能。