具有一键优化功能的CRT治疗慢性心力衰竭的临床观察

Clinical Observation of Cardiac Resynchronization Therapy with Quick Opt Optimization in Chronic Heart Failure Patients

目的观察具有一键优化功能的心脏起搏与不具一键优化功能的心脏再同步化治疗(cardiac resynchronization therapy,CRT)慢性心力衰竭(chronic heart failure,CHF)的临床疗效。方法 19例慢性心力衰竭患者接受CRT治疗,并根据起搏器是否具有"一键优化"功能分为"一键优化"组(n=10)和"超声优化"组(n=9),于术前收集患者的相关资料,术后1周、3个月分别行一键优化及超声优化评价CRT治疗的临床疗效。结果一键优化与超声优化的最佳优化房室(AV)间期(131.00±7.40ms VS 134.00±15.80ms)及最佳优化心室(VV)间期(18.50±9.50ms VS17.00±13.60ms)比较差异无统计学意义。通过定期随访,发现两组起搏器植入术后3个月,6个月经优化后心胸比、左心室舒张末压、左心室射血分数及6分钟步行试验两组间并无统计学差异(除BNP术前及术后3月两组间有统计学差异外)。结论有一键优化功能的CRT治疗慢性心力衰竭的临床疗效不亚于常规超声心动图优化的CRT,且一键优化功能方便、快捷给临床工作带来更多方便性。

Objective To observe the clinical efficacy of cardiac resynchronization therapy （ CRT ） with or without quick Opt optimized heart pacemaker in chronic heart failure patients. Methods 19 patients received CRT device implantation and were divided into quick Opt optimized group （ N= 10 ） and ultrasonic optimized group （ N = 9 ） according to whether pacemaker had optimizational function. The relevant data of patients were collected before operation. At 1 week and 3 months after CRT implantation, quick Opt optimized heart pacemaker and ultrasonic optimization were performed to evaluate the clinical effects. Results The optimal AV interval （ 131.00 ±7.40 ms VS 134.00±15.80ms）and the optimal W interval 18.50±9.50ms VS 17.00± 13.60ms）ere not statistically different between the quick Opt optimized group and ultrasonic optimized group （ P 〉 0.05 ）. Through regular follow- up, there were no significant differences between the two groups in terms of the cardiothoracic ratio, left ventricular end-diastolic pressure, left ventricular ejection fraction and 6-minute walking test after three months and six months of pacemaker implantation, apart from significant differences in BNP before and after three months of operation between the two groups. Conclusions The clinical efficacy of CRT with quick Opt optimized function in treating chronic heart failure is no less than that of CRT optimized by routine ultrasonic cardiogram. Moreover, it is convenient and quick to perform in clinical practice. Therefore, it could be a replacement therapy for ultrasonic optimization.