中华心律失常学杂志
中華心律失常學雜誌
중화심률실상학잡지
CHINESE JOURNAL OF CARDIAC ARRHYTHMIAS
2013年
3期
192-195
,共4页
王丽娟%孙国建%陈建明%何浪%钟诚%吴巧元%沈法荣
王麗娟%孫國建%陳建明%何浪%鐘誠%吳巧元%瀋法榮
왕려연%손국건%진건명%하랑%종성%오교원%침법영
心力衰竭%右心室起搏%心脏再同步治疗
心力衰竭%右心室起搏%心髒再同步治療
심력쇠갈%우심실기박%심장재동보치료
Heart failure%Right ventricular pacing%Cardiac resynchronization therapy
目的 探讨长期右心室起搏的心力衰竭患者升级为心脏再同步治疗(CRT)后,随访观察临床疗效.方法 共22例患者均为长期右心室起搏,并在随访中发现,心功能逐渐下降,左心逐渐增大,符合我国CRT升级适应证,予以升级为CRT,观察术前、术后6个月患者的基线特征变化,QRS时限的变化,以及超声心动图指标变化.结果 普通起搏器升级为CRT后,随访6个月,QRS时限明显缩短[(181±19) ms对(142±22) ms,P<0.001],左心室射血分数(LVEF)明显升高[(0.33±0.02)对(0.42±0.08),P<0.001],左心室收缩末期内径,左心室舒张末期内径均有明显减小.患者平均改善心功能I级(NYHA分级)(P<0.001).二尖瓣反流程度也较升级前减轻.比较升级治疗后有反应组和无反应组患者的特点,不合并冠心病的患者较合并冠心病的患者有反应者更多,其余基线资料差异无统计学意义.结论 长期右心室起搏的心力衰竭患者升级为CRT后,心功能明显改善.
目的 探討長期右心室起搏的心力衰竭患者升級為心髒再同步治療(CRT)後,隨訪觀察臨床療效.方法 共22例患者均為長期右心室起搏,併在隨訪中髮現,心功能逐漸下降,左心逐漸增大,符閤我國CRT升級適應證,予以升級為CRT,觀察術前、術後6箇月患者的基線特徵變化,QRS時限的變化,以及超聲心動圖指標變化.結果 普通起搏器升級為CRT後,隨訪6箇月,QRS時限明顯縮短[(181±19) ms對(142±22) ms,P<0.001],左心室射血分數(LVEF)明顯升高[(0.33±0.02)對(0.42±0.08),P<0.001],左心室收縮末期內徑,左心室舒張末期內徑均有明顯減小.患者平均改善心功能I級(NYHA分級)(P<0.001).二尖瓣反流程度也較升級前減輕.比較升級治療後有反應組和無反應組患者的特點,不閤併冠心病的患者較閤併冠心病的患者有反應者更多,其餘基線資料差異無統計學意義.結論 長期右心室起搏的心力衰竭患者升級為CRT後,心功能明顯改善.
목적 탐토장기우심실기박적심력쇠갈환자승급위심장재동보치료(CRT)후,수방관찰림상료효.방법 공22례환자균위장기우심실기박,병재수방중발현,심공능축점하강,좌심축점증대,부합아국CRT승급괄응증,여이승급위CRT,관찰술전、술후6개월환자적기선특정변화,QRS시한적변화,이급초성심동도지표변화.결과 보통기박기승급위CRT후,수방6개월,QRS시한명현축단[(181±19) ms대(142±22) ms,P<0.001],좌심실사혈분수(LVEF)명현승고[(0.33±0.02)대(0.42±0.08),P<0.001],좌심실수축말기내경,좌심실서장말기내경균유명현감소.환자평균개선심공능I급(NYHA분급)(P<0.001).이첨판반류정도야교승급전감경.비교승급치료후유반응조화무반응조환자적특점,불합병관심병적환자교합병관심병적환자유반응자경다,기여기선자료차이무통계학의의.결론 장기우심실기박적심력쇠갈환자승급위CRT후,심공능명현개선.
Objective To evaluate the benefit of cardiac resynchronization therapy (CRT)in patients with chronically right ventricle paced heart failure.Methods We studied 22 patients who had a previously implanted pacemaker or implantable cardioverter defibrillator.All these patients were chronically RV paced resulted in a tremendous LV function deterioration and treated by upgrading to CRT or CRT-D.To observe the changes of the baseline character including ORS duration,and echocardiography at least 6 months after upgrading to CRT or CRT-D.Results CRT significantly reduced the mean ORS duration [(181±19)ms vs(142±22)ms,P <0.001],and increased the LV ejection fraction[(0.33±0.02) vs(0.42±0.08),P<0.001].Left ventricular endsystolic and end-diastolic dimensions were reduced significantly.After upgrade to CRT,the patients cardiac function was improved by an average of one grade of NYHA fuctional class (P<0.001).Mitral regurgitation was also significantly improved.Response to CRT upgrade was independent of the underlying rhythm,QRS duration,duration of prior RV pacing,or LV function at baseline.But the reduction of the QRS duration was associated with CRT response,and patients with ischaemic cardiomyopathy were less likely to respond to CRT than those with nonischaemic disease.Conclusion This study demonstrated that CRT improved heart function in the patients with chronic right ventricular pacing.