心脏再同步化起搏对慢性充血性心力衰竭患者血流动力学的影响(附1例分析)  

The Influence of Cardiac Resynchronization on Hemodynamics of the Patients with Chronic Congestive Heart Failure(1 Case Report)

作　　者：王兵[1,2] 江洪[3] 陈玲[2] 丁峰[2] 董艳芬[2] 孙玉玲[2] 

机构地区：[1]武汉大学医学部研究生院,武汉430072 [2]砀山县人民医院心内科,安徽砀山235300 [3]武汉大学人民医院心内科,武汉430060

出　　处：《医学综述》2013年第8期1512-1514,共3页Medical Recapitulate

摘　　要：目的观察心脏再同步化起搏(CRT)对慢性充血性心力衰竭患者血流动力学的影响。方法应用心脏再同步化起搏治疗,电极植入采用左锁骨下静脉穿刺,左心室电极植入冠状窦后外侧分支,右心室电极植入右心室心尖部,右心房电极植入右心耳,观察其血流动力学变化。结果患者成功植入CRT起搏器,无并发症,左心室电极植入冠状窦后外侧分支,各项测试参数满意。随访期间,心功能分级,左心室射血分数均明显改善,左心室收缩末容积明显缩小,QRS波时限由180 ms缩短至130 ms,心室起搏比例超过95%。结论 CRT起搏确能使慢性充血性心力衰竭患者血流动力学明显改善。Objective To observe the effects of cardiac resynchronization therapy（CRT） on hemody- namics of the patients with chronic congestive heart failure. Methods A patient with dilated cardiomyopathy was treated with cardiac resynchronization therapy. With intravenous puncture technique under left collar- bone, the left ventricular lead was implanted in posterolateral branch of the coronary sinus, the right ventricu- lar electrode in the right ventricular apex, and the right atrial electrode in the right atrial appendage. The hemodynamic changes were observed. Results CRT pacemaker was successfully imbedded without any com- plications. Left ventricular lead was implanted in posterolateral branch of the coronary sinus, and all paramters determined were satisfactory. During the follow-up, the patient was found to have the increment of heart func- tion and the improved left ventricular ejection fraction with more than 95% of ventricular capture. The left ventricular end-stolic volume was decreased remarkably and QRS duration was decreased from 180 ms to 130 ms. Conclusion CRT pacing can indeed improve the hemodynamics in the patient with chronic conges- tive heart failure.

关 键 词：心血管病学 充血性心力衰竭 心脏再同步化治疗 血流动力学 

分 类 号：R318.1[医药卫生—生物医学工程] R541.61[医药卫生—基础医学]