右房双室起搏治疗慢性心力衰竭的近期疗效

目的:观察右房双室起搏治疗慢性心力衰竭的近期疗效.方法:选择NYHAⅢ级-Ⅳ级、LVEF≤35%、QRS时限≥120 ms、窦性心律的CHF患者30例,成功植入三腔起搏器后,以起搏器植入术前及术后1月的6 min步行距离、MQOL、QRS波时限、LVEDD、LVEF、TPSD、NT-proBNP为评价指标,观察右房双室...

The short-term clinical observation of the right atrium and biventricular pacing therapy in patients with chronic heart failure

Objective: To observe the short-term curative effect of the right atrium and biventricular pacing in patients with chronic heart failure.Methods: Thirty patients who had LVEF less than or equal to 35%,a QRS duration greater than or equal to 0.12 seconds,sinus rhythm and NYHA function Class Ⅲ or ambulatory Class Ⅳ heart failure symptoms with optimal medical therapy were collected after the successful implantation of CRT/CRTD.Took 6-minute walk distance,Minnesota quality-of-life score(MQOL),QRS duration in surface electrocardiogram,left ventricular end-diastolic dimension(LVEDD),LVEF,the difference between systolic time to peak from left interventricular septum to the basal segment of lateral wall(TPSD) and NT-proBNP as the efficacy evaluation indexes on the day before the implantation of CRT/CRTD and the first month after that,to observe the short-term curative effect of the the right atrium and biventricular pacing in patients with chronic heart failure.Results: After the right atrium and biventricular pacing for one month,the seven efficacy evaluation indexes were significantly improved(P<0.05).The 6-minute walk distance was increased from(267±34) m to(318±37) m.The MQOL was decreased from(30±7) to(19±8).The QRS duration was shortened from(171±22) ms to(130±8) ms.The LVEDD was reduced from(78±6) mm to(67±8) mm.The LVEF was improved from(29±5)% to(37±6)%.The TPSD dropped from(108±29) ms to(59±7) ms.The NT-proBNP was lowered from(3 286±1 702) pg/ml to(1 871±901) pg/ml.Conclusion: The curative effect of the the right atrium and biventricular pacing is definite.In patients with severe congestive heart failure,sinus rhythm,and left bundle-branch block.