双腔起搏器治疗肥厚型梗阻性心肌病16例报告

The Clinical Observing of Treatment in Hypertrophic Obstructive Cardiomyopathy (HOCM)by dual-chamber pacing(DCPG)

目的 观察双腔起搏器治疗难治性HOCM的临床效果及安全性。方法 16例难治性HOCM患者,植入双腔起搏器并将A-V间期程控至100-120ms,随访1-8年观察临床症状及体征,心脏彩超检查,观察双腔起搏器术前,术后1天、7天、3月及1年的IVS、LVPW、LVOT、VP、LVEF的数值。结果 5例临床症状消失,9例明显减轻或改善,2例改善不明显,但未加重。4例发生过晕厥患者未再出现晕厥,心功能明显改善,随访中所有病例存活。术后的UCG随访:IVS、LVPW有缩小的趋势;LVOT增宽、VP下降,其LVOT增加值越高、VP下降值越大其临床症状改善越明显,反之临床症状改善不明显;LVEF也有改善。结论 双腔起搏可作为一种治疗药物难治性HOCM的有效方法。

Objectives To observe and evaluate the clinical treatment effectiveness of DCPG as well as its safety. Method sixteen obstinate pa- tients were implanted DCPGS, the corresponding data of before and post operation, such as IVS, LVPW, LVOT, VP, LVEF, were recorded. Results The clinical symptom of 5 patients disappeared, 9 alleviated obviously, 2 inert but no aggravation, ever syncope 4 patients have no repetitiousness and their cardiac function ameliorated obviously. The follow-up studies show that the patients survival, the UCG show the values of IVS and LVPW reduced, LVOT widen, VP declined, The higher of the LVOT and the lower of VP, the better of the clinical treatment effectiveness, vice versa. Meanwhile, the LVEF ameliorated too.Conclusion The DCPG is a very useful method to treat the HOCM, which may has no effectiveness through drug therapy.