完全性左束傳導阻滯

完全性左束傳導阻滯 = Complete Left Bundle Branch Blockage, Heart Block 的一種。下面的資料話要裝心脈起搏器 pacemaker 或 cardiac resynchronization pacing or CRT 先得。

圖片參考：http://www.fashionguide.com.tw/Forum/ImgMsg/2007/0528/182740917.jpg

Treating BBB
As we have noted, the heart depends on the bundle branches. Without them, the electrical impulse is not delivered to the ventricles. Block in both bundle branches, therefore (a condition called complete heart block,) can be fatal.
Fortunately, it is quite uncommon for stable RBBB or LBBB to progress to complete heart block. Thus, despite the fact that BBB is a common finding on routine ECGs, it is an uncommon reason for implanting pacemakers.
Still, there are a few conditions in which people with bundle branch block require pacemakers:
1) When “conduction system disease” is bilateral, and is associated with a heart attack:We have previously noted that RBBB plus left anterior hemiblock should not be particularly alarming. This is true except in this one instance – where the block occurs acutely with a heart attack. Here, the conduction system disease tends to be unstable, and can progress to complete heart block. These patients often need pacemakers.
2) When bundle branch block is associated with syncope (loss of consciousness):When a patient with bundle branch block experiences syncope, in general an electrophysiology study should be considered to test for impending complete heart block. A permanent pacemaker eliminates the problem.
3) In certain patients with dilated cardiomyopathy:In patients who have dilated cardiomyopathy and either complete or incomplete bundle branch block, a new form of pacing – called cardiac resynchronization pacing or CRT – has now been shown to improve symptoms and to prolong life. CRT should now be strongly considered in any patient with heart failure and bundle branch block. Click here to read more about CRT.
As we have seen, bundle branch block causes the ventricles to beat sequentially (one after another) instead of simultaneously. This discoordination of the normal pattern of ventricular contraction diminishes the efficiency of the heart beat. In a person with a normal heart, the loss of efficiency is inconsequential. But in a person with dilated cardiomyopathy this loss of efficiency can be critical, and can contribute greatly to symptoms of heart failure. Resynchronization pacing restores much of this efficiency by pacing both the right and left ventricles simultaneously. In patients who have heart failure from dilated cardiomyopathy and bundle branch block, resynchronization pacing has become an important component to therapy.
http://heartdisease.about.com/cs/arrhythmias/a/BBB_4.htm

2007-06-16 01:50:56 補充：
左右束枝傳導阻滯 (RBBB ; LBBB)左、右束支傳導阻滯及左分支前、後分支傳導阻滯。臨床上除心音分裂外無其它特殊表現。診斷主要依靠心電圖。左束支阻滯 LBBB 常表示有彌漫性的心肌病變。最常見的病因為冠心病、也見于高血壓病、風濕性心臟病、急性及慢性肺原性心臟病、心肌炎、心肌病、傳導系統的退行性疾病右束支傳導阻滯 者RBBB 無心臟病的証據，這種孤立的右束支傳導阻滯常見，其發生率隨年齡而增加。http://www2.kfsyscc.org/sophia/pejournal/cardiology/arrythmia.htm#rbbb

2007-06-18 01:36:45 補充：
左右束枝傳導阻滯 (RBBB ; LBBB) 是心律不正的病症。只有安裝心脈起搏器一途，才能確保心臟跳動正常。

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