简介：Permanentpacemakerimplantisacommonlyperformedcardiacprocedurefortreatmentofbradycardiaorconductionsystemabnormality.Withconventionalrightventricular(RV)pacingaleadisimplantedattheRVapexorontheRVseptum.However,RVapicalorRVseptalpacingcausesiatrogenicleftbundle-branchblockandventriculardyssynchronyandcanleadtoadversecardiacremodeling,apacing-mediatedcardiomyopathy,andcongestiveheartfailure.Alternatively,permanentHis-bundlepacingusestheintrinsicrapidly-conductingHis-Purkinjesystemtoactivatetheventricle,therebymaintaining(orsometimesevenrestoring)ventricularsynchrony.ManypatientsmayderivebenefitfrompermanentHis-bundlepacing.

简介：ObjectiveToobservetheeffectofaccessorypathway(AP)conductiononPJintervalinpatientswithWolff-Parkinson-Whitesyndrome.Methods129patientswithasinglemanifestationofAPwhounderwentsuccessfulradiofrequencyablation(RFCA)wereincluded.Patientsweredividedinto10groupsaccordingtoAPlocation.ThePRintervals,QRSdurationsandthePJintervalsweremeasuredusingsimultaneous12-leadECGbeforeandafterablation.ThePJintervalsbeforeablationwerecomparedwiththatafterablation.Theatrioventricular(AV)conductiontimeviaatrioventricularnode-HisconductionsystembeforeablationwerecomparedwiththePRintervalsafterablation.Theventriculardepolarizationtimeviaatrioventricularnode-HisconductionsystembeforeablationwerecomparedwiththeQRSdurationsafterablation.Deltawaveswerecomparedbetweeneachtwogroups.Results(1)ThePJintervalsofrightposterior(RP)groupandrightposteroseptal(RPS)groupbeforeablationwereshorterthanthatafterablation(RPgroup226±18msvs236±19ms,P<0.01,RPSgroup221±18msvs238±31ms,P<0.05,respectively).(2)Therewerenosignificantdifferencesbetweentheatrioventricular(AV)conductiontimeviaatrioventricularnode-HisconductionsystembeforeablationandthePRintervalsafterablation.(3)Theventriculardepolarizationtimeviaatrioventricularnode-HisconductionsystemofRPgroupandRPSgroupbeforeablationwereshorterthanthePRintervalsafterablation(RPgroup79±12msvs87±9ms,P=0.01;RPSgroup70±13msvs86±9ms,P<0.05,respectively).(4)ThedeltawavesofRPgroupandRPSgroupwerelongerthanthatofleftposteriorgroupandleftposteroseptalgroup(P<0.05).ConclusionPJintervalisshortenedbyAPconductionwhichpre-excitesthegenerallastexcitedpartofleftventricle.ItisdeterminedbyAPlocationandtheextentofpreexcitation.

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