CRT疗效与兼顾“房室结优先”关系的研究前景

Future research of the relationship between cardiac resynchronization therapy and AVN perference and AVN first

心脏再同步化治疗(CRT)为目前国际指南所推荐用于伴双室收缩不同步的心力衰竭患者。该治疗可显著降低患者再入院率和病死率,带来较大的公共卫生效应。但仍有30%的患者接受CRT治疗后无应答。而提高应答率是心脏科医生面临的最大挑战。为异于传统的CRT的思路,有人提出了双心室起搏,若同时兼顾房室结自身的下传,形成室性融合波,能最大程度的模拟心室生理性激动;从而改善心力衰竭患者对CRT的应答,改善预后及降低治疗成本等。我们通过目前对CRT效果与QRS波宽度和形态关系的研究进展,共同探讨兼顾房室结的双心室起搏,与传统双室起搏相比,是否具有逆转左心室重构的可能。

Cardiac resynchronization therapy(CRT) has been recommended for the heart failure patients by the international guidelines,whose double chamber contraction are not synchronous.The treatment can significantly reduce patients readmission rate and mortality and bring greater public health effect.But there are still 30% of patients,who have no answer after CRT treatment.And improving the response rate is one of the biggest challenges for cardiologists.For differing from the traditional CRT thought,somebody puts forward the double ventricular pacemaker,if it gives attention to the atrioventricular intrinsic conduction own downloading,and forms AVN preference and AVN-first wave,which can simulate ventricular physiological excited in maximum degree;Thus it can improve the heart failure patients response to CRT and improve prognosis and reduce the treatment cost,etc.At present,through the CRT effect and the QRS wave width and form the research progress of relationship,we give attention to atrioventricular node double ventricular pacemaker compared with the traditional bientricular pacing,and whether it can reverse left ventricular remodeling.