【正文】 arrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at ，其傳導已恢復 ，伴或不伴一度房室阻滯 I型房室阻滯 ，最長間歇 3 sec ， 或最小 HR 40 bpm III 類適應證 : 兒童 , 青少年 , 和先天性心臟的起搏治療 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at Section IH: 特殊情況的起搏治療 肥厚梗阻性心臟病 特發(fā)性擴張性心肌病 心臟移植 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at I類 : ，如前述 I 類適應證的各種情況 IIa類 : 無 IIb類 : ，在靜息或應激情況下有明顯流出道梗阻者 I, IIa, 和 IIb 類適應證 : 肥厚梗阻性心肌病 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at III 類適應證 : 肥厚梗阻性心肌病 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at I 類 ? 合并竇房結功能不全或房室阻滯的 I 類適應證情況見前述 IIa 類 : ? 藥物難治的擴張型心肌病或缺血性心肌病，心功能 NYHA分級 III/IV ， QRS 時限 (?130 msec), LVDD ?55mm, LVEF ?35%， 可考慮雙心室起搏治療 I 和 IIa類適應證 : 特發(fā)性擴張型心肌病 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at IIb類 : 無 III類 ： – 無癥狀 – 有癥狀但藥物治療有效 – 有癥狀缺血性心肌病，介入或手術治療可望緩解病情 III 類和 IIb類適應證 : 特發(fā)性擴張型心肌病 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at I 類 : ? 預計不能恢復的有癥狀的心動過緩 /變時功能不良，符合 I類適應證 . IIa類 : 無 IIb類 : ? 暫時性有癥狀的心動過緩 /變時功能不良，但可能持續(xù)數(shù)月和需要干預治療 . III類 : ? 手術后無癥狀的心動過緩 . IIII 類適應證 : 心臟移植 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at 慢性房性心動過速 , 預計不能恢復竇性 房室阻滯 需要房室同步 VDD DDD DDDR VVI VVIR 需要頻率 應答 需要心房起搏 需要頻率應答 是 否 是 否 是 否 否 是 VVI VVIR 房室阻滯的起搏器選擇 是 否 需要頻率 應答 否 是 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at DDDR VVI DDD AAI 房室傳導受損或關注將來發(fā)生房室阻滯 竇房結功能不全 需要房室同步 需要頻率應答 是 否 需要頻率應答 是 否 否 是 VVIR AAIR 需要頻率應答 是 否 是 竇房結功能不良的起搏器選擇 Gregoratos G. et al. ACC/AHA/NASPE 2021 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. 2021. Available at 否