CAJ | 학술논문

目的通过对本院植入的20例三腔起搏器患者进行随访观察,分析心脏再同步治疗(CRT)的临床疗效及对CRT无反应的原因.方法研究接受CRT治疗的20例患者,观察术后的临床有效率和超声心动图有效率,总结此期间的心脏不良事件.结果植入术后临床症状改善12例,临床有效率60%;超声心动图有效者11例(55%),平均左心室射血分数提高0.10.有3例死亡(15%);1例左心室电极导线脱位,经复位后起搏良好;1例左心室电极起搏阈值升高,被迫关闭起搏器;临床无反应者4例.缺血性心肌病合并前壁心肌梗死或慢性肾功能不良的患者CRT效果欠佳;宽QRS心力衰竭患者对CRT反应优于窄QRS患者.心房颤动伴缓慢心室率患者CRT同样有效.结论 CRT能改善心力衰竭患者的左心室收缩功能和左心室重构,减少二尖瓣反流.对CRT的反应与入选患者的基础心脏病和QRS波的宽度有关.
목적 통과대본원식입적20례삼강기박기환자진행수방관찰,분석심장재동보치료(CRT)적림상료효급대CRT무반응적원인.방법 연구접수CRT치료적20례환자,관찰술후적림상유효솔화초성심동도유효솔,총결차기간적심장불량사건.결과 식입술후림상증상개선12례,림상유효솔60%;초성심동도유효자11례(55%),평균좌심실사혈분수제고0.10.유3례사망(15%);1례좌심실전겁도선탈위,경복위후기박량호;1례좌심실전겁기박역치승고,피박관폐기박기;림상무반응자4례.결혈성심기병합병전벽심기경사혹만성신공능불량적환자CRT효과흠가;관QRS심력쇠갈환자대CRT반응우우착QRS환자.심방전동반완만심실솔환자CRT동양유효.결론 CRT능개선심력쇠갈환자적좌심실수축공능화좌심실중구,감소이첨판반류.대CRT적반응여입선환자적기출심장병화QRS파적관도유관.
Objective To investigate the effect of cardiac resynchronization therapy (CRT) and the problem of non-response to CRT in patients with chronic heart failure. Methods Twenty patients[(64±10.9) yrs,5 women, 15men] underwent CRT. Conventional echocardiography was performed in each patient before implantation and at 6 months post implantation. Results The clinical response rate was 60% and echocardio-graphic response rate was 55% at 6 month follow-up. Average EF increased 10%. Three patients died and 1 pa-tient was found to have increased left electrode thresholds. One electrode dislocation occurred and recannulation was required. Four patients had no response to CRT. The response rate to CRT was lower in patients with a nar-row QRS or ischemic cardiomyopathy. Conclusion CRT is an effective treatment for chronic heart failure pa-tients. Non-response to CRT may berelated to the cause of heart failure and narrow QRS.