心脏再同步化治疗心力衰竭的死亡原因分析

Analysis of death causes of heart failure patients received cardiac resynchronization therapy

目的：探讨心脏再同步化治疗（cardiac resynchronization therapy,CRT）心力衰竭患者的死亡原因。方法：53例NYHA心功能Ⅲ~Ⅳ级的药物难治性心力衰竭患者均成功置入CRT系统,术后常规应用标准抗心力衰竭药物。随访1~80个月,观察患者病情变化及结果。结果：7例死亡,其中5例为心源性死亡,2例为非心源性死亡。心源性死亡主要是心功能恶化和心律失常所致。心功能恶化与基础心脏病和术后心房颤动的发生有关。结论：CRT患者的死亡有多种类型,其中心源性死亡与基础心脏疾病和术后房颤的发生有关。

Objective：To explore the causes of death in patients with heart failure who have received cardiac resynchronization therapy （CRT）. Methods：Fifty-three patients with NYHA class Ⅲ or Ⅳ heart failure who had failed to respond to standard pharmacologic therapy were treated by CRT. The routine medicine was applied after the operation. The follow-up lasted from 1 to 80 months, and the outcome was observed. Results：Seven patients died during the follow-up, 5 of whom were cardiac death and 2 non-cardiac death, Cardiac death was mainly induced by deterioration of heart function and cardiac arrhythmia. Deterioration of heart function was related to primary heart disease and occurrence of atrial fibrillation. Conclusions：Causes of death in patients with CRT are varied and cardiac death is associated with the primary heart disease and the occurrence of atrial fibrillation.