双心室起搏治疗充血性心力衰竭的血流动力学观察  

The hymodynamic observation on patients with congestive heart failure treated by biventricular pacing

作　　者：华伟[1] 王方正[1] 张澍[1] 张奎俊[1] 尤士杰[1] 牛国栋[1] 马坚[1] 陈新[1] 

机构地区：[1]中国医学科学院中国协和医科大学心血管病研究所阜外心血管病医院电生理研究室,北京100037

出　　处：《中华心律失常学杂志》2000年第2期90-93,共4页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　观察双心室起搏治疗充血性心力衰竭的血流动力学效果。　方法　充血性心力衰竭伴心室内阻滞患者 6例 ,男性 5例 ,女性 1例 ,平均年龄 5 4岁。心功能均在 ～ 级 (NYHA) ,体表心电图平均 QRS时限为 141ms。患者均进行了双心室起搏 ,左心室起搏通过冠状静脉窦植入 2 187或2 188导线 ,于其血管分支内进行左心室起搏。左、右心室导线通过 Y形转接器与双腔起搏器连接。术后应用超声心动图检查 ,观察双心室起搏的血流动力学效果。　结果　双心室起搏后 ,患者心功能得到明确改善 ,左室射血分数从 0 .17提高至 0 .2 5 ,左室充盈时间延长 ,二尖瓣返流量减少 ,心功能从 ～ 级(NYHA)改善至 级。　结论　初步血流动力学观察提示 ,双心室起搏改善充血性心力衰竭患者的心功能。Objective To observe the hymodynomic effect of biventricular pacing in patients with congestive heart failure. Method There were 6 patients,5 male and 1 female,mean age of 54 years old,with refractory congestive heart failure and left bundle branch block.The mean QRS duration was 141 ms.All of them received biventricular pacing and the 2187 or 2188 coronary vein lead was insert into the branch of coronary sinus to pace left ventricle. Results After biventricular pacing,the cardiac function was significantly improved.The LVEF was increased from 16 7% to 25 2%.The left ventricular filing time increased and mitral regurgitation reduced.The NYHA class of the patients improved from Ⅲ Ⅳ to Ⅱ. Conclusion The biventricular pacing could improve hymodynomic effect in patients with congestive heart failure and left bundle branch block.

关 键 词：双心室起搏 充血性心力衰竭 血流动力学 

分 类 号：R541.6[医药卫生—心血管疾病]