心脏再同步化与常规治疗对心力衰竭患者心房颤动影响的比较

Comparison of the influence of ordinary drug therapy and cardiac resynchronization therapy in patients with severe congestive heart failure and atrial fibrillation

目的探讨心脏再同步化(CRT)与常规治疗对心力衰竭(简称心衰)患者心房颤动(简称房颤)的影响。方法选择行CRT、CRTD治疗的患者,作为CRT组。选择同期心衰行常规药物治疗的患者,作为对照组。比较两组患者治疗后,阵发性房颤、永久性房颤的发生率,以及房颤患者的预后差异。结果:①对照组房颤的发生率较CRT组高(阵发性房颤9/46 vs 5/47;永久性房颤24/46 vs 11/47,P均<0.05)。②常规药物治疗下房颤患者的死亡率高于窦性心律患者(P<0.05)。结论 CRT治疗后,房颤发生率较低,房颤并心衰患者的死亡率亦降低,CRT组心衰临床症状明显改善,心功能提高,运动耐量增加,生活质量提高。

Objective To investigate the influence of ordinary drug therapy and cardiac resynchronization therapy （CRT） in patients with severe congestive heart failure and atrial fibrillation （AF）. Methods Patients who were implanted with a biventricular pacing system or CRTD were enrolled in the CRT group. Patients given ordinary drug therapy were enrolled as the control group at the same time. New-onset of paroxysmal AF, permanent AF and prognosis were compared between two groups. Results First, when the patients were treated, new-onset AF in comparison group was more than the CRT group（ paroxysmal AF 9/46 vs 5/47 ; permanent AF 24/46 vs 11/47, all P 〈 0.05 ）. Secondly, the mortality of patients in AF was higher than that in SR when they were all treated with ordinary drug （ P 〈 0.05 ）. Conclusions Patients after CRT, the occur of AF is distinctly reduced, the mortality of patients with CHF and AF is also reduced. Com- pared with control group, patients in the CRT group have less clinical symptoms, improved cardiac function, increased exercises and improved living quality.