心脏再同步化起搏治疗随访

目的探讨心脏再同步化起搏治疗(CRT)随访的相关技术细节。方法22例难治性充血性心力衰竭(简称心衰)患者(男14例、女8例),年龄59.5±7.8(47~74)岁,其中扩张型心肌病16例、高血压性心脏病6例。按常规方法置入双室起搏器后,按一定程序对起搏系统及患者的临床综合反应随访观察,根据患者反应及时对起搏系统参数进行优化。结果随访22±13.01(1~48)个月,双室起搏辅以优化的起搏参数及药物治疗。心衰临床症状改善,心功能提高,运动耐量增加,生活质量提高,心脏重塑进程延缓,因心衰住院事件减少。结论CRT必须从置入起搏器的即刻开始进行动态随访、优化起搏参数。

Follow-up of cardiac resynchronization pacing therapy for refractory heart failure

Objective To study the follow-up effect of cardiac resynchronous therapy(CRT) for refractory heart failure.Methods Twenty-four patients with refractory heart failure (RHF) were as follows: Male 14,female 8,aged 47-74(59.5±7.8)years.Sixteen of them had dilated cardiomyopathy and 6 cardiomyopathy was induced by essential hypertension.All the patients had indication of CRT.All patients were given right atrium and biventricular or sole biventricular pacing,and received strict follow-up and the pacing parameters were optimized dynamically in order.Results The patients mean follow-up duration was 22.0±13.01 months(1-48)months.By optimizing pacing parameters individually and rational medication,CRT could reverse ventricular remodeling,and decrease hospitalization event and mortality for heart failure.At the same time,patients′clinic symptoms,heart function,quality of life (QOL) and distance of 6 minutes walk test(6MWT) had improved significantly.Furthermore,the all observed index were statistically significant.Conclusions Compared with ordinary pacemaker,biventricular pacing has some special characteristics.Therefore,dynamic following-up and individual parameter optimization are the key to successful CRT.