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编者按临床实践中,起搏治疗通常是常规经右心途径进行的。但对于某些患者,尤其右心房室显著增大、三尖瓣重度反流者,常规起搏术式往往会增加手术耗时及透视时间,而且植入失败、电极脱位等概率高。此时,可替代的操作方式包括:(1)外科开胸或经胸腔镜心外膜起搏;(2)经冠状静脉窦起搏静脉分支;(3)穿间隔左心室心内膜起搏。本刊盛琴慧等(页码:647-649)和李康等(页码:649-651)均报道了经常规右心途径起搏失败后的对策。盛琴慧等医师采取经冠状静脉窦左心室起搏。该方法的“利”为:若术程顺利、部位理想,实现有效左心室起搏,将有助于改善心功能。而且,
Editor’s Note: In clinical practice, pacing therapy is usually performed routinely via the right-heart approach. However, in some patients, especially the right atrium was significantly increased, severe tricuspid regurgitation, conventional pacing tend to increase surgery time and fluoroscopy time, and implantation failure, electrode dislocation and other high probability. In this case, alternative modes of operation include: (1) surgical thoracotomy or thoracoscopic epicardial pacing; (2) coronary sinus pacing vein branching; (3) septal left ventricular endocardial pacing . Sheng et al. (Pages 647-649) and Li Kang et al. (Page 649-651) reported measures after failure of conventional right ventricular pacing. Sheng Qin Hui and other physicians to take the coronary ventricular left ventricular pacing. The method of “Lee” as follows: If the operation smoothly, the site ideal, to achieve effective left ventricular pacing, will help improve heart function. and,