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双心室同步起搏治疗顽固性心力衰竭的临床研究 被引量:6

CLINICAL STUDY OF OBSTINATE HEART FAILURE TREATED BY SYNCHRONOUS BIVENTRICULAR PACING
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摘要 目的:观察双心室同步起搏对扩张型心肌病顽固性心力衰竭的治疗效果。方法:10例扩张型心肌病病人,男6例,女4例,所有病人符合NYHA心功能III^IV级,心电图呈窦性心律,完全性左束支传导阻滞,QRS时限>120 m s,射血分数<35%,左室内径>60 mm。因严重心力衰竭而长期卧床,经多种抗心衰药物治疗效果不佳。分别植入右心房、右心室和冠状静脉左室分支电极导线,行房室顺序双心室同步起搏,观察起搏前、后QRS时限、NYHA心功能分级、左室内径、射血分数及6 m in步行试验的变化。结果:右心房、右心室和左心室电极导线感知和起搏参数均符合起搏要求。起搏后QRS时间明显缩短(P<0.01),(NYHA)心功能分级进一步改善(P<0.01),左室射血分数及6 m in步行增加(P<0.01)。结论:双心室同步起搏治疗可缓解心衰的症状,改善心功能,增加射血分数,提高运动耐量。 Objective:To assess the effect of synchronous biventricular pacing on obstinate heart failure in patients with dilated cardiomyopathy. Methods:Ten patients with heart failure of New York Heart Association(NYHA) functional class Ⅲ to Ⅳ, QRS 〉 120ms, left ventricular ejection fraction (LVEF) 〈 35%, left ventricular end diastolic diameter 〉 60mm and refractory to drug therapy were selected including six males and four females. Biventricular synchronous pacing was performed after implantation of an atrio - biventricular pacemaker. Serial LVEF, NYHA class heart function and 6 minutes hall walk were evaluated bcforc and after up to 6 months of pacing . Results: Thc acute pacing and sensing thresholds measured during the implanting procedure were normal. The QRS duration was significantly shortened by biventricular pacing in comparison with baseline( P 〈0.01 ). NYHA functional class reduced dramatically ( P 〈 0.01 ), LVEF increased ( P 〈 0.01 ), 6 minutes hall walk improved steadily( P 〈 0.01 ). Conclusion: Synchronous biventricular pacing is likely associated to the improvements of hemodynamics, heart function, exercise tolerance and symptoms.
出处 《内蒙古医学院学报》 2006年第5期394-396,共3页 Acta Academiae Medicinae Neimongol
基金 内蒙古教育厅资助项目(NJ05125)
关键词 双心室同步起搏 心力衰竭 心功能 synchronous biventricular pacing heart failure heart function
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