提高CRT患者疗效的机理和方法

Mechanisms for Improving Efficiency of Cardiac Resynchronization Therapy

心脏再同步化治疗(CRT)是治疗顽固性心力衰竭的有效手段。通过运用以组织多普勒为基础的超声技术,合理评价心脏机械不同步收缩,选择合适的患者,并指导选择左室电极理想的起搏位置、设置最佳房室间期及室间间期,是目前实现提高CRT疗效的主要方法。但还需要更多的以临床事件为终点的数据以证实这些观点。应用新的超声方法,以心脏电标测方法指导电极放置,以腔内电图的方法优化参数设置可能有助于进一步提高CRT的疗效。

Cardiac resynchronization therapy （ CRT） is a useful method to treat end stage chronic heart failure patients. Based the applications of tissue Doppler image, the following methods have been used to improve the efficiency of CRT： to evaluate mechanical asynchrony of left ventricle and to choose appropriate patients before operation ; to select appropriate site for left ventricular electrode during operation, and to set optimal AV and VV delay after operation. For more efficiency of CRT,some new methods may be useful such as to use new methods of ultrasound, to guide appropriate site of electrodes by mapping, and to use IEGM for optimal parameter setting.