心力衰竭严重威胁人类生命和健康，器械治疗是终末期心衰在传统药物治疗之外的重要选择。我们对心衰患者及心衰模型犬行心脏再同步化和绝对不应期电刺激并进行疗效评估，证明了不同器械治疗方式在慢性心衰合并传导阻滞时除改善收缩强度和同步性，还通过影响心肌磷脂酰胆碱参与的脂肪酸代谢，在代谢层面促进衰竭心脏的功能恢复、改善结构重构和心功能。左束支区域起搏夺获正常的心脏传导束，是新的心衰器械治疗模式。本课题建立犬右心室快速起搏及房室结消融的心衰合并完全房室传导阻滞模型，证明左束支区起搏时的急性血流动力学改变，心衰相关基因的调控及LPA1-Gi-RhoA-p38 MAPK和LPA1-Gi-PPAR通路蛋白的表达对磷脂酰胆碱代谢的影响，明确左束支区起搏优化磷脂酰胆碱参与的代谢途径，延缓并改善心衰时心肌微环境及心肌重构，在慢性心衰治疗中发挥多重保护作用。研究结果预期为左束支区起搏治疗慢性心力衰竭的机制提供新线索。

Heart failure seriously threatens human life and health, and device therapy is an important option for end-stage heart failure in addition to traditional medical treatment. We performed cardiac resynchronization and absolute refractory period electrical stimulation in patients with heart failure and heart failure models and evaluated the efficacy. It was proved that different device treatment methods improve the contraction strength and synchronization when chronic heart failure is combined with conduction block. It also promotes the functional recovery of the failed heart and improves structural remodeling and cardiac function at the metabolic level by affecting the fatty acid metabolism and myocardial phosphatidylcholine. The left bundle branch pacing captures the normal cardiac conduction tracts, which is a new treatment mode of heart failure device therapy. This study establishes a model of heart failure combined with complete atrioventricular block in dogs with rapid right ventricular pacing and atrioventricular node ablation, proving the acute hemodynamic changes during left bundle branch pacing, the regulation of heart failure-related genes, and LPA1 -Gi-RhoA-p38 MAPK and LPA1-Gi-PPAR pathway protein expression effects on phosphatidylcholine metabolism, clarify the left bundle branch pacing to optimize the metabolic pathway in phosphatidylcholine, improve myocardium during heart failure, the microenvironment and myocardial remodeling, play multiple protective roles in the treatment of chronic heart failure. The results of the study are expected to provide new clues to the mechanism of left bundle branch pacing in the treatment of chronic heart failure.