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目的 总结心力衰竭(简称心衰)患者行轨道法植入心脏再同步化治疗(CRT)或CRT除颤器(CRT-D)左室心内膜电极方法及疗效.方法 选取本院因无法行冠状静脉窦植入CRT/CRT-D左室心外膜电极的心衰患者6例,通过穿刺房间隔先后建立股静脉-房间隔-股动脉轨道和股动脉-房间隔-锁骨下静脉轨道,完成左室心内膜电极植入术,并比较手术前后心脏超声、心电图及心功能指标.结果 6例患者均成功通过轨道法植入CRT/CRT-D左室心内膜电极,术后1周随访QRS时限较前明显缩窄[(140.83±10.52)ms vs(166.83±13.60)ms,P＜0.05],射血分数较前明显增加[(0.37±0.05)vs(0.27±0.04),P＜0.05],心功能NYHA分级较前升高1～2级,患者心慌、胸闷等临床症状明显改善;术后1例发生左室电极穿孔,床边心脏超声示心包少量积液,予以左室电极重置后好转,其余无明显并发症.结论 轨道法植入CRT/CRT-D左室心内膜电极安全、有效,是部分无法通过冠状窦植入心外膜电极的重要辅助术式.“,”Objective To summarize the method and effect of orbital implantation of cardiac resynchronization therapy (CRT) or CRT and cardioverter defibrillator (CRT-D) combined with implantation of left ventricular endometrium electrode in patients with heart failure (HF). Method Six patients with HF who were unable to perform implantation of CRT/CRT-D left ventricular epicardial electrode coronary venous sinus in our hospital were selected.Femoral vein-atrial septum-femoral artery orbit and femoral artery-atrial septum-subclavian vein orbit were established successively by puncturing atrial septum, and then complete left ventricular endocardial electrode implantation.Cardiac ultrasound, electrocardiogram and cardiac function were compared before and after surgery. Result All the 6 patients successfully implanted CRT/CRT-D left ventricular endocardial electrode by orbital method.QRS duration was significantly narrowed after 1 week follow-up[ (140.83±10.52) ms vs (166.83±13.60) ms, P＜0.05], and the ejection fraction was significantly increased[ (0.37±0.05 vs (0.27±0.04), P＜0.05].After surgery, one patient suffered from left ventricular electrode perforation.Bedside cardiac ultrasound showed a small amount of effusion in the pericardium, which was improved after resetting the left ventricular electrode. Conclusion Orbital method implantation of CRT/CRT-D left ventricular endocardial electrode is safe and effective.