中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2011年
2期
90-93
,共4页
陈浩%佟佳宾%邹彤%王志蕾%顾成圻%杨杰孚
陳浩%佟佳賓%鄒彤%王誌蕾%顧成圻%楊傑孚
진호%동가빈%추동%왕지뢰%고성기%양걸부
心脏再同步治疗%左心室起搏阈值管理%起搏%阈值
心髒再同步治療%左心室起搏閾值管理%起搏%閾值
심장재동보치료%좌심실기박역치관리%기박%역치
Cardiac resynchronization therapy%Left ventricular capture management%Pacing%Threshold
目的 目前在国内使用的心脏再同步治疗(CRT)起搏器及心脏再同步治疗除颤器(CRT-D)中,仅美敦力公司的Concerto具有左心室起搏阈值管理(LVCM)功能.本文初步探索植入Concerto患者,LVCM功能的准确性及临床意义.方法 5例药物治疗无效的严重心力衰竭患者植入了Concerto型CRT-D,术后打开LVCM功能,起搏器自动记录每天起搏阈值变化情况,并在每一个随访时间点收集LVCM自动测算的左心室起搏阈值并与人工测算值进行对比.结果 所有患者术后在满足测试条件后自动开启LVCM功能,并在事先设置的时间点自动测试起搏阈值,根据阈值自动调整输出;术后1～2个月起搏阈值波动较大.LVCM测算的左心室起搏阈值与手动测算值完全符合率为83.3%(20/24),如果按筹值0.5 V计算,二者符合率为96.8%(23/24).结论 LVCM功能与手工测试具有很高的符合率;使用此功能能最大限度地保证左心室或双心室有效同步起搏,对提高CRT术后疗效具有重要临床意义.
目的 目前在國內使用的心髒再同步治療(CRT)起搏器及心髒再同步治療除顫器(CRT-D)中,僅美敦力公司的Concerto具有左心室起搏閾值管理(LVCM)功能.本文初步探索植入Concerto患者,LVCM功能的準確性及臨床意義.方法 5例藥物治療無效的嚴重心力衰竭患者植入瞭Concerto型CRT-D,術後打開LVCM功能,起搏器自動記錄每天起搏閾值變化情況,併在每一箇隨訪時間點收集LVCM自動測算的左心室起搏閾值併與人工測算值進行對比.結果 所有患者術後在滿足測試條件後自動開啟LVCM功能,併在事先設置的時間點自動測試起搏閾值,根據閾值自動調整輸齣;術後1～2箇月起搏閾值波動較大.LVCM測算的左心室起搏閾值與手動測算值完全符閤率為83.3%(20/24),如果按籌值0.5 V計算,二者符閤率為96.8%(23/24).結論 LVCM功能與手工測試具有很高的符閤率;使用此功能能最大限度地保證左心室或雙心室有效同步起搏,對提高CRT術後療效具有重要臨床意義.
목적 목전재국내사용적심장재동보치료(CRT)기박기급심장재동보치료제전기(CRT-D)중,부미돈력공사적Concerto구유좌심실기박역치관리(LVCM)공능.본문초보탐색식입Concerto환자,LVCM공능적준학성급림상의의.방법 5례약물치료무효적엄중심력쇠갈환자식입료Concerto형CRT-D,술후타개LVCM공능,기박기자동기록매천기박역치변화정황,병재매일개수방시간점수집LVCM자동측산적좌심실기박역치병여인공측산치진행대비.결과 소유환자술후재만족측시조건후자동개계LVCM공능,병재사선설치적시간점자동측시기박역치,근거역치자동조정수출;술후1～2개월기박역치파동교대.LVCM측산적좌심실기박역치여수동측산치완전부합솔위83.3%(20/24),여과안주치0.5 V계산,이자부합솔위96.8%(23/24).결론 LVCM공능여수공측시구유흔고적부합솔;사용차공능능최대한도지보증좌심실혹쌍심실유효동보기박,대제고CRT술후료효구유중요림상의의.
Objective Medtronic Concerto(R) cardiac resynchronization therapy defibrillator(CRT-D) is the only one device used in mainland China with left ventricular capture management(LVCM)algorithm.Our aim was to assess the clinical application and accuracy of LVCM in patients with Concerto(R) CRT-D implantation.Methotis Concerto(R) CRT-D systems were implanted into 5 patients with drug-resistant heart failure.Daily fluctuation of LV thresholds acquired by the LVCM algorithm up to 6-month-follow-up.LV threshold measurements by LVCM were compared with manual LV threshold tests at periodic visits.Results All high threshold detections and all automatic modulation of LV pacing output were adjusted appropriately,LV threshold fluctuated markedly in first 2 months.LVCM tests were identical to manual LV threshold tests in 20 out of 24 attempts(83.3%).The proportion of LVCM threshold tests within one programming step of the manual threshold test was 96.8%(23/24).Conclusion This study demonstrated that LVCM algorithm is accurate,reliable,and clinically equivalent to the manual LV threshold test.LVCM could ultimately result in complete LV capture and improve clinical effects of CRT.
