心脏再同步治疗慢性心力衰竭随访疗效分析

目的探讨心脏再同步化治疗(CRT)对慢性充血性心力衰竭近远期治疗的效果。方法心力衰竭患者48例,男31例、女17例,年龄62.0±15.6(35～80)岁,其中扩张型心肌病28例,高血压性心脏病2例,缺血性心肌病l3例,Ⅲ度房室传导阻滞5例。心功能Ⅲ级(NYHA分级)34例、Ⅳ级14例。植入CRT系统(含CRTD),随访23.4±15.8个月。结果48例中有良好反应者32例,对治疗无明显反应者11例。死亡9例,其中2例猝死,4例死于心力衰竭恶化。结论CRT疗效肯定,定期随访和程控,将有助于减少无反应者。CRTD有助于降低猝死的发生。

Long term therapeutic effect of cardiac resynchronization therapy on patients with congestive heart failure

Objective To analyze the long term therapeutic effect of cardiac resynchronization therapy （CRT） on patients with congestive heart failure（CHF）. Methods Forty -eight patients with CHF were enrolled, including 31 male and 17 female with mean age 62.0 ± 15.6 years. The etiologies of heart disease were dilated cardiomyopathy （ n = 34 ） , hypertension cardiomyopathy （ n = 2 ） , third degree atrioventricular block （ n = 5 ） and ischemic myocardiopathy （ n = 13 ） , with New York Heart Association （NYHA） class Ⅲ（n = 34） and class Ⅳ （n = 14）. The patients received CRT（D） implantation, with mean follow-up period 23.4 ± 15.8 months. Results Thirty-two patients were responders for CRT, while 11 were non-responders. 9 patients died during follow-up, 2 of those died from sudden death, 4 of those died from worsening heart function. Conclusions Improvement of clinical symptoms has been proved after CRT, and regular follow-up and programming CRT may reduce non-responders for CRT. CRTD can reduce the prevalence of sudden death.