Initial experiences of maintaining atrioventricular intrinsic conduction during cardiac resynchronization therapy in non-responders  

作　　者：WANG Ru-xing GUO Tao HUA Bao-tong HAN Ming-hua ZHAO Ling YANG Jun LI Shu-min LIU Zhong-mei LUO Zhi-ling 

机构地区：[1]Department of Cardiology, First Affiliated Hospital of Kunming Medical College, Kunming, Yunnan 650032, China [2]Department of Cardiology, Affiliated Hospital of Nanjing Medical University Wuxi People's Hospital, Wuxi, Jiangsu 214023, China

出　　处：《Chinese Medical Journal》2009年第20期2455-2460,共6页中华医学杂志（英文版）

摘　　要：Background Cardiac resynchronization therapy （CRT） is a major breakthrough in therapy for advanced heart failure patients; however, a number of key clinical research questions remain, perhaps most importantly the issue of why apparently suitable patients do not respond to CRT. Methods Seven patients, six males and one female, aged （56.43±6.13） years, all diagnosed with dilated cardiomyopathy, were included in this study. They were all non-responders to CRT who underwent routine optimization postoperatively, and received optimal drug therapy. On the basis of biventricular pacing, titrating various atrioventricular （AV） intervals were performed to get the true fusional QRS complexes composed of biventricular pacing and AV intrinsic conduction. Then, the effects of AV intrinsic conduction during CRT were evaluated. Results On the setting of AV intrinsic conduction during CRT, the true fusional QRS complexes were the narrowest, and all patients showed alleviation of symptoms, improvement of exercise tolerance, life quality and hemodynamic parameters during more than 6 months of follow-up. Conclusions Titrating AV intervals to get the true fusional QRS complexes composed of biventricular pacing and AV intrinsic conduction will be beneficial for non-responders to CRT. Maintaining AV intrinsic conduction during CRT may decrease the rates of non-resoonders to CRT.Background Cardiac resynchronization therapy （CRT） is a major breakthrough in therapy for advanced heart failure patients; however, a number of key clinical research questions remain, perhaps most importantly the issue of why apparently suitable patients do not respond to CRT. Methods Seven patients, six males and one female, aged （56.43±6.13） years, all diagnosed with dilated cardiomyopathy, were included in this study. They were all non-responders to CRT who underwent routine optimization postoperatively, and received optimal drug therapy. On the basis of biventricular pacing, titrating various atrioventricular （AV） intervals were performed to get the true fusional QRS complexes composed of biventricular pacing and AV intrinsic conduction. Then, the effects of AV intrinsic conduction during CRT were evaluated. Results On the setting of AV intrinsic conduction during CRT, the true fusional QRS complexes were the narrowest, and all patients showed alleviation of symptoms, improvement of exercise tolerance, life quality and hemodynamic parameters during more than 6 months of follow-up. Conclusions Titrating AV intervals to get the true fusional QRS complexes composed of biventricular pacing and AV intrinsic conduction will be beneficial for non-responders to CRT. Maintaining AV intrinsic conduction during CRT may decrease the rates of non-resoonders to CRT.

关 键 词：heart failure cardiac resynchronization therapy atrioventricular intrinsic conduction NON-RESPONDER 

分 类 号：R686[医药卫生—骨科学]