emcardioНеотложная кардиология и кардиоваскулярные рискиEmergency Cardiology and Cardiovascular Risks journal2616-633XБелорусский государственный медицинский университет10.51922/2616-633X.2025.9.1.2478emcardio-125Research ArticleИнтересный клинический случайAn interesting clinical caseСлучай успешной стимуляции проводящей системы сердца при атриовентрикулярной блокаде у ребенка после коррекции врожденного порока сердцаA case of successful stimulation of the cardiac conduction system in atrioventricular block in a child after correction of a congenital heart defectКадочкинВ. О.KadochkinV. O.

220013, пр. Независимости 64А, Минск

64A Nezavisimosti ave., Minsk, 220013

vitkadok@gmail.comПилантД. А.PilantD. A.

220013, пр. Независимости 64А, Минск

64A Nezavisimosti ave., Minsk, 220013

КолбикВ. Г.KolbikV. G.

220013, пр. Независимости 64А, Минск

64A Nezavisimosti ave., Minsk, 220013

ИлбутьТ. А.IlbutT. A.

220013, пр. Независимости 64А, Минск

64A Nezavisimosti ave., Minsk, 220013

ДроздовскийК. В.DrozdovskyK. V.

220013, пр. Независимости 64А, Минск

64A Nezavisimosti ave., Minsk, 220013

ГУ «Республиканский научно-практический центр детской хирургии»State Institution “Republican Scientific and Practical Center of Pediatric Surgery”2025110920259124782482Copyright © Кадочкин В.О., Пилант Д.А., Колбик В.Г., Илбуть Т.А., Дроздовский К.В., 20252025Кадочкин В.О., Пилант Д.А., Колбик В.Г., Илбуть Т.А., Дроздовский К.В.Kadochkin V.O., Pilant D.A., Kolbik V.G., Ilbut T.A., Drozdovsky K.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://emcardio.bsmu.by/jour/article/view/125

Проблема выбора оптимального метода электрокардиостимуляции у пациентов детского возраста становится крайне актуальной. У детей чаще возникают долгосрочные побочные эффекты постоянной электрокардиостимуляции, что обусловлено особенностями детского организма, анатомией врожденного порока сердца и пожизненной потребностью в электрокардиостимуляторе. Стимуляция области ЛНПГ может быть рассмотрена как эффективный альтернативный метод кардиостимуляции у детей с послеоперационной атриовентрикулярной (АВ)-блокадой после коррекции врожденных и приобретенных пороков сердца.

В данной статье представлен клинический случай успешной стимуляции области левой ножки пучка Гиса у ребенка 11 лет с послеоперационной АВ-блокадой после радикальной коррекции тетрады Фалло, выполненной впервые в педиатрической практике в Республике Беларусь. Более физиологическое сокращение левого желудочка при СПСС способствует снижению риска развития ЭКС-индуцированной кардиомиопатии и прогрессирования хронической сердечной недостаточности, что делает данный метод предпочтительным в педиатрической практике.

The problem of choosing the optimal method of electrocardiostimulation in children is becoming extremely relevant. Children are more likely to experience long-term side effects of constant electrocardiostimulation, due to the specific features of a child’s body, the anatomy of congenital heart defect and the lifelong need for an electrocardiostimulator. Left bundle branch area pacing (LBBP) can be considered as an effective alternative method of pacing in children with postoperative atrioventricular (AV) block following correction of congenital and acquired heart defects.

This article presents a clinical case of successful left bundle branch area pacing in an 11-year-old child with postoperative AV block following radical correction of the Fallot tetrad, which was the first to be performed in pediatric practice in the Republic of Belarus. A more physiological contraction of the left ventricle in cardiac conduction system pacing helps to reduce the risk of pacemaker-induced cardiomyopathy and the progression of chronic heart failure, which makes this method preferable in pediatric practice.

стимуляция области ЛНПГстимуляция проводящей системы сердцаЭКСВПСЭКС-индуцированная кардиомиопатияатриовентрикулярная блокадаleft bundle branch pacingcardiac conduction system pacingpacemakerCHDpacemaker-induced cardiomyopathyatrioventricular blockReferencesGuidelines on cardiac pacing and cardiac resynchronization therapy. European Heart Journal, 2013, vol. 34, pp. 2281–2329.Guidelines on cardiac pacing and cardiac resynchronization therapy. European Heart Journal, 2013, vol. 34, pp. 2281–2329.Merchant F.M., Mittal S. Pacing-Induced Cardiomyopathy. Card Electrophysiol Clin, 2018, vol. 10(3), pp. 437-445. doi: 10.1016/j.ccep.2018.05.005.Merchant F.M., Mittal S. Pacing-Induced Cardiomyopathy. Card Electrophysiol Clin, 2018, vol. 10(3), pp. 437-445. doi: 10.1016/j.ccep.2018.05.005.Safak E., Ince H., Gkouvatsou L. et al. Pacing-induced cardiomyopathy in chronic right ventricular apical pacing: a midterm follow-up study. Eur J Med Res, 2019, vol. 24(1), pp. 23. doi: 10.1186/s40001-019-0386-5.Safak E., Ince H., Gkouvatsou L. et al. Pacing-induced cardiomyopathy in chronic right ventricular apical pacing: a midterm follow-up study. Eur J Med Res, 2019, vol. 24(1), pp. 23. doi: 10.1186/s40001-019-0386-5.Moak J.P., Hasbani K., Ramwell C. et al. Dilated cardiomyopathy following right ventricular pacing for AV block in young patients: resolution after upgrading to biventricular pacing systems. Cardiovasc Electrophysiol, 2006, vol. 17, pp. 1068–1071.Moak J.P., Hasbani K., Ramwell C. et al. Dilated cardiomyopathy following right ventricular pacing for AV block in young patients: resolution after upgrading to biventricular pacing systems. Cardiovasc Electrophysiol, 2006, vol. 17, pp. 1068–1071.Kim J.J., Friedman R.A., Eidem B.W. et al. Ventricular function and long-term pacing in children with congenital complete atrioventricular block. J Cardiovasc Electrophysiol, 2007, vol.18, pp. 373-377.Kim J.J., Friedman R.A., Eidem B.W. et al. Ventricular function and long-term pacing in children with congenital complete atrioventricular block. J Cardiovasc Electrophysiol, 2007, vol.18, pp. 373-377.Gebauer R.A., Tomek V., Salameh A. et al. Predictors of left ventricular remodelling and failure in right ventricular pacing in the young. Eur Heart J, 2009, vol. 301, pp. 97-104.Gebauer R.A., Tomek V., Salameh A. et al. Predictors of left ventricular remodelling and failure in right ventricular pacing in the young. Eur Heart J, 2009, vol. 301, pp. 97-104.Gebauer R.A., Tomek V., Kubuš P. et al. Differential effects of the site of permanent epicardial pacing on left ventricular synchrony and function in the young: implications for lead placement. Europace, 2009, vol. 11(12), pp. 1654-1659.Gebauer R.A., Tomek V., Kubuš P. et al. Differential effects of the site of permanent epicardial pacing on left ventricular synchrony and function in the young: implications for lead placement. Europace, 2009, vol. 11(12), pp. 1654-1659.Qian Liu, Jing Yang, Zhou Bolun et al. Comparison of cardiac function between left bundle branch pacing and right ventricular outflow tract septal pacing in the shortterm: A registered controlled clinical trial International. Journal Cardiology, 2021, vol. 322, pp. 70–76.Qian Liu, Jing Yang, Zhou Bolun et al. Comparison of cardiac function between left bundle branch pacing and right ventricular outflow tract septal pacing in the shortterm: A registered controlled clinical trial International. Journal Cardiology, 2021, vol. 322, pp. 70–76.Zhang S., Zhou X., Gold M.R. Left bundle branch pacing: JACC review topic of the week. J Am Coll Cardiol, 2019, vol. 74(24), pp. 3039–3049. doi: 10.1016/j.jacc.2019.10.039.Zhang S., Zhou X., Gold M.R. Left bundle branch pacing: JACC review topic of the week. J Am Coll Cardiol, 2019, vol. 74(24), pp. 3039–3049. doi: 10.1016/j.jacc.2019.10.039.Gordon A., Jimenez E., Cortez D. Conduction system pacing in pediatrics and congenital heart disease, a single center series of 24 patients [published online ahead of print June 9, 2022]. Pediatr Cardiol. 2022. doi: 10.1007/s00246-022-02942-9.Gordon A., Jimenez E., Cortez D. Conduction system pacing in pediatrics and congenital heart disease, a single center series of 24 patients [published online ahead of print June 9, 2022]. Pediatr Cardiol. 2022. doi: 10.1007/s00246-022-02942-9.Scott M., Needleman J.S., Kean A.C. Conduction System Pacing in Pediatrics and Congenital Heart Disease: A Case Report and Literature Review. J Innov Card Rhythm Manag. 2024, vol. 15(2), pp. 5749-5755. doi: 10.19102/icrm.2024.15021.Scott M., Needleman J.S., Kean A.C. Conduction System Pacing in Pediatrics and Congenital Heart Disease: A Case Report and Literature Review. J Innov Card Rhythm Manag. 2024, vol. 15(2), pp. 5749-5755. doi: 10.19102/icrm.2024.15021.Lyon S., Dandamudi G., Kean A.C. Permanent His-bundle pacing in pediatrics and congenital heart disease. J Innov Card Rhythm Manag, 2020, vol. 11(2), pp. 4005–4012.Lyon S., Dandamudi G., Kean A.C. Permanent His-bundle pacing in pediatrics and congenital heart disease. J Innov Card Rhythm Manag, 2020, vol. 11(2), pp. 4005–4012.Chubb H., Mah D., Dubin A.M., Moore J. Conduction system pacing in pediatric and congenital heart disease. Front Physiol, 2023, vol. 24(14), pp. 1154629. doi: 10.3389/fphys.2023.1154629.Chubb H., Mah D., Dubin A.M., Moore J. Conduction system pacing in pediatric and congenital heart disease. Front Physiol, 2023, vol. 24(14), pp. 1154629. doi: 10.3389/fphys.2023.1154629.

The authors declare that there are no conflicts of interest present.