双心室再同步治疗难治性心力衰竭

Ventricular resynchronization therapy on intractable heart failure

目的观察双心室再同步治疗对药物难治性心力衰竭的临床疗效。方法扩张型心肌病10例,心功能Ⅳ级,合并完全性左束支阻滞,QRS正常时限超过130ms,左心室舒张末内径超过55mm,左心室射血分数小于0.35,置入三腔双心室同步起搏器治疗,观察术后临床症状及超声心电图指标变化。结果术后患者心功能改善1～2级,心电图QRS时限明显缩短,心胸比例、二尖瓣反流面积、左心室舒张末内径和左心房舒张末内径明显减小,左心室射血分数和左心室短轴缩短率明显增加(P<0.05)。结论双心室再同步治疗可明显改善伴室内传导阻滞的难治性心力衰竭患者的心脏收缩功能。

Objectives To investigation the therapeutic effect of ventricular resynchronization therapy on intractable heart failure. Methods Ten patients with dilated cardiomyopathy （ had complete left bundle branch block, low ejection fraction 〈0.35, QRS duration 〉130 ms, left ventricular end-diastolic diameter 〉55 mm, and New York Heart Association functional class Ⅳ ） were implanted with biventricular pacemaker. And clinical symptoms and some parameters of cardiac function were observed. Results Symptoms and cardiac function of patients were significantly improved after implantation compared with before （P〈0.05 or 0.01）. Conclusions Ventricular resynchronization therapy is an effective way in treatment of intractable heart failure accompanied by complete left bundle branch block.