双心室起搏治疗慢性心力衰竭伴心室内传导阻滞患者的近期疗效  

Clinical observation of biventricular pacing in treating chronic heart failure and intraventricular conduction delay

作　　者：张清[1] 王海昌[1] 刘兵[1] 李伟杰[1] 程何祥[1] 李成祥[1] 李媛[1] 王小燕[1] 

机构地区：[1]第四军医大学西京医院心内科,陕西西安710032

出　　处：《心脏杂志》2006年第2期214-215,共2页Chinese Heart Journal

摘　　要：目的观察双心室起搏治疗慢性心力衰竭（心衰）的临床效果。方法慢性心衰患者13例均伴心室内传导阻滞，体表心电图QRS波时限为146±9ms，心功能（NYHA）Ⅲ～Ⅳ级，超声心动图显示左心室射血分数（LVEF）为0．28±0．06，左心室舒张末径（LVEDD）为68±5mm。患者植入三腔起搏器行心房感知，双心室起搏。结果术后体表心电图QRS波时限缩短至122±7ms（P〈0．01），心功能平均提高1级。术后1月超声心动图显示LVEF增至0．36±0．06（P〈0．05），舒张期充盈改善，二尖瓣返流减少。结论双心室起搏可有效改善慢性心衰伴心室内传导阻滞患者近期的心功能。AIM To observe the clinical effect of biventricular pacing in the treatment of chronic heart failure and intraventricular conduction delay. METHODS Thirteen patients with chronic heart failure and intraventricular conduction delay were enrolled in the study. The mean QRS width was 146 ± 9 ms, heart function （NYHA） was class Ⅱ - Ⅲ LVEF was 0.28 ±0.06, and LVEDD was 68 ±45 mm. All of the patients received biventricular synchronous pacing. RESULTS After biventricular synchronous pacing, the mean QRS width was 122 ±7 ms（P 〈0.01, vs pretreatment）, the NYHA class of the patients was improved from class Ⅱ - Ⅲ to class Ⅱ - Ⅲ, the LVEF increased to 0.36 ± 0.06 （ P 〈 0. 05, vs pretreatment）, the left ventricular filling time was increased and mitral regurgitation was reduced. CONCLUSION The biventricular synchronous pacing improves the hemodynamic effect in patients with chronic heart failure and intraventricular conduction delay.

关 键 词：双心室起搏 心力衰竭 心室内传导阻滞 

分 类 号：R318.11[医药卫生—生物医学工程] R541.61[医药卫生—基础医学]