心脏再同步化治疗心力衰竭的临床效果

Clinical effect of resynchronization therapy in patients with chronic heart failure

目的:观察心脏再同步化治疗(CRT)对充血性心力衰竭患者心功能的影响。方法:对6例有CRT适应证的充血性心力衰竭患者置入三腔起搏器,通过起搏参数优化使心脏房室收缩趋向正常顺序及室间收缩同步化。结果:6例患者均成功置入了三腔起搏器,左室电极靶血管,5例位于左后侧静脉,1例右束支传导阻滞患者因为置入左后侧静脉膈肌跳动而改为心大静脉。术后3个月,患者的胸闷气促症状明显改善,生活能够自理,心功能可达到NYHAⅡ级;QRS宽度均较术前缩短;左室射血分数较术前提高,左室舒张末期内径减小;程控仪测试参数显示,与置入三腔起搏器前相比较夜间心率有所降低,活动度增加。结论:CRT通过改善心脏收缩的同步性,提高左室射血分数,从而改善心功能,提高生活质量和运动能力。

Objective： To observe the clinical effect of cardiac resynchronization therapy（CRT） in patients with chronic heart failure（CHF）.Methods： Six patients with CHF accorded with CRT indication were received CRT and made the heart loculus contract trended normal order and ventriculars contract synchronization through pacing parameter optimized.Results： Six patients all succeeded to be implanted tri-chamber pacemakers.left ventricular lead target vessel,5 patients located left posterior lateral vein,1 patient with right bundle branch block was changed great cardiac vein because diaphragma subsultus.Patients′ stuffiness,tachypnea obviously improved in three month,life can self-care,heart function attainability NYHAⅡ,QRS width was shorten compare with preoperative,postoperative three month left ventricular EF increased compare with preoperative,left ventricular end diastolic dimension grow down.Program control device test parameter showed heart rate decreased and activity increased.Conclusions： CRT improve cardiac systolic synchronism,enhance left ventricular EF,thus improve heart function;enhance life quality and motor ability.