经胸阻抗监测在慢性心力衰竭患者中的临床应用观察

Clinical utility of intrathoracic impedance monitoring in patients with chronic heart failure

目的评估植入性器械经胸阻抗监测功能识别慢性心力衰竭患者中液体潴留的有效性。方法对10例植入带有经胸阻抗监测功能植入式器械的慢性心力衰竭患者进行定期随访，观察经胸阻抗的变化，并分析其可能原因。结果10例患者出现经胸阻抗的变化并达液体潴留报警阈值水平4例共7次报警，生活方式变化、停用抗心力衰竭药物、感染及再次植入术引起各1次，另3次为心功能下降所致。结论经胸阻抗监测在慢性心力衰竭患者中是一项有用的工具，能尽早预警心力衰竭患者的失代偿。

Objective The aim of this study is to evaluate the implantable device capable of measuring iutrathoracic impedance to identify potential fluid overload before heart failure hospitalization. Methods Ten patients with chronic heart failure were implanted with a special implantable device which can measure intrathoracic impedance. The data of impedance were retrospectively identified before and after device implantation during follow-up. And analyses of impedance as well as the reasons of impedance changes were performed. Results Four patients experienced 7 intrathoracie impedance fluid index threshold crossing events at nominal threshold value（ 60Ω） during follow-up in all 10 patients. The occurrence of threshold crossing events was associated with life style change, stop taking anti-heart failure drug, infection, and re-implanted operation through alert events analysis. Three patients experienced heart failure deterioration. Conclusion The intrathoracie impedance monitoring is a useful tool for the clinical management of heart failure patients. Monitoring of impedance may provide early warning of impending decompensation and diagnostic information for titration of medication.