专家述评DOI:10.11724/jdmu.2023.03.01传导束起搏预防与治疗心力衰竭的新进展王楠,董颖雪(大连医科大学附属第一医院心内科,辽宁大连116011)[摘要]心脏起搏可治疗心动过缓以及心力衰竭(心衰),但以往的起搏方式包括右室起搏、双室再同步化起搏均不是最生理性的起搏方式,还可能导致心衰的发生,或使心衰改善困难。传导束起搏(CSP)可以真正做到在传导束病变远端进行生理性心脏传导系统的重建,在心衰的预防及部分与传导束有关的心衰根治方面意义重大。随着术者经验的提高、临床技术的推广,传导系统起搏将为患者带来更大的临床获益。[关键词]传导束起搏;心力衰竭;心动过缓;左束支传导阻滞;房室结消融[中图分类号]R4[文献标志码]A文章编号:1671-7295(2023)03-0193-05Conductionsystempacingonheartfailure:progressandprospectWANGNan,DONGYingxue(DepartmentofCardiology,theFirstAffiliatedHospitalofDalianMedicalUniversity,Dalian116011,China)[Abstract]Cardiacpacinghasalonghistoryinthetreatmentofbradycardiaandheartfailure.However,previouspacingmodalities,includingrightventricularpacinganddualventricularresynchronizationpacing,arenotthemostphysiologicalpacingmodalitiesandpossiblyleadtotheoccurrenceofheartfailureordifficultyintheimprovementofheartfailure.Conductionsystempacing,asalandmarkleapinthehistoryofcardiacpacing,cantrulyachievethereconstructionofthephysiologicalcardiacconductionsystematthedistalendoftheconductionlesion.Itplaysagreatroleinthepreventionandtreatmentofheartfailure,especiallyheartfailurecausedbyconductionsystemproblems.Withtheimprovementofoperatorexperienceandthepromotionofclinicaltechnologies,conductionsystempacingwillbringgreaterclinicalbenefitstomorepatients.[Keywords]conductionsystempacing;heartfailure;bradycardia;leftbundlebranchblock;atrioventricularnodeablation传导束起搏(conductionsystempacing,CSP)是近年来起搏领域的一项重大革新技术,包括希氏束起搏(his-bundlepacing,HBP)和左束支起搏(left-bundlebranchpacing,LBBP),因其通过直接激动自身心脏传导系统,可保持心脏电传导和机械收缩的同步性,故为真正意义上的生理性起搏。与传统的心脏再同步化治疗(cardiacresynchronizationtherapy,CRT)即双室起搏(bi...