双室右房三心腔起搏在充血性心力衰竭治疗中的初步应用

Preliminary application of biventricular pacing to treat congestive heart failure(CHF) for dilated cardiomyopathy (DCM) by InSync 8040 Pacemaker.

目的 观察InSync80 4 0起搏器治疗扩张型心肌病 (DCM )伴充血性心力衰竭 (CHF)的疗效。方法 患者 ,男 7例 ,女 1例 ,年龄 4 8～ 75 (5 8 7± 10 2 )岁 ,均为扩张性心肌病伴充血性心衰 ,且有完全性左束支传导阻滞或左前分支传导阻滞 ,植入InSync80 4 0起搏器。左心室起搏通过冠状静脉窦植入Medtronic公司生产的 2 187电极 ,置于冠状静脉窦的分支静脉起搏左心室 ,左右心室电极和右房电极导线与InSync 80 4 0起搏器相连接。 结果 以InSync80 4 0起搏器起搏并辅以合适的房室间期 (AVD) ,患者心力衰竭的症状明显改善 ,NYHA心功能分级从Ⅲ -Ⅳ级提高到Ⅰ -Ⅱ级 ,超声心动图示心功能指标改善 ,核素检查示心室收缩较术前协调 ,起搏后心电图QRS时限缩短。结论 初步临床应用表明 。

Objective To observe the efficacy of biventricular pacing to treat congestive heart failure for dilated cardiomyopathy by InSync 8040 pacemaker.Methods Patients,7 males and 1 female,(58 7±10 2)-year-old on average (48～75 years),with refractory congestive heart failure and complete bundle block or left anterior branch block for dilated cardiomyopathy,were implanted with InSync 8040 pacemakers,The 2187 ventricular leads were inserted to the branches of coronary sinus to pace left ventricles.All leads were connected with InSync 8040 pacemakers made by Medtronic Company.Results Heart functions were remarkably improved after biventricular pacing at optimal atrioventricular delay(AVD).The NYHA class of heart function was increased from Ⅲ～Ⅳ to Ⅰ～Ⅱ.The improvement of heart function and reduction of mitral regurgitation were found in echocardiogram.The ventricular resynchronization was showed in radionuclide.QRS waves became narrow after pacing.Conclusion Biventricular pacing by InSync 8040 pacemaker is an effective way to deal with patients with congestive heart failure.