三腔双心室起搏治疗20例充血性心力衰竭患者的近期临床效果  

Acute efficacy of three chamber biventricular pacing in patients with congestive heart failure

作　　者：华伟[1] 王方正[1] 张澍[1] 张奎俊[1] 牛国栋[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》2001年第1期38-40,共3页Chinese Journal of Cardiac Arrhythmias

摘　　要：目的　观察三腔双心室同步起搏治疗充血性心力衰竭的临床效果。方法　充血性心力衰竭伴心室内阻滞患者 2 0例 ,男性 16例 ,女性 4例 ,平均年龄 5 4.7岁。心功能均在 - 级 ( NYHA分级 ) ,体表心电图平均 QRS时限为 142 .6 ms。患者均进行了三腔双心室同步起搏 ,起搏电极导线分别置于右心房、右心室以及经由冠状静脉窦置于一支心脏静脉起搏左心室。观察双心室起搏前后左心室射血分数变化以及体表心电图 QRS波变化。结果　双心室同步起搏后 ,患者心功能得到明显改善 ,左心室射血分数 ( left ventricular ejection fraction,L VEF)从 2 4.4%提高至 32 .1% ,左心室充盈时间延长 ,二尖瓣返流量减少。心功能从 - 级改善至 - 级。QRS时限由术前的 142 .6 m s缩短至 12 4.8ms。　结论　初步临床观察提示 ,三腔双心室同步起搏可有效改善充血性心力衰竭伴心室内阻滞患者的心功能。Objective To observe the clinical effect of biventricular pacing in patients with congestive heart failure. Methods There were 20 patients,16 males and 14 females,mean age of 54.7 years old,with refractory congestive heart failure and left bundle branch block.The mean QRS width was 142.6 ms.All of them received three chamber biventricular pacing and the left ventricular pacing lead was inserted into a cardiac vein through coronary sinus. Results After biventricular pacing,the heart function was significantly improved.The LVEF was increased from 24.4% to 32.1%.The left ventricular filling time was increased and mitral regurgitation reduced.The QRS width was reduced from 142.6 ms to 124.8 ms.The NYHA class of cardiac function was improved from Ⅲ Ⅳ to Ⅱ Ⅲ. Conclusion The biventricular pacing could improve heart function of patients with congestive heart failure and left bundle branch block.

关 键 词：充血性心力衰竭 三腔双心室起搏 治疗 

分 类 号：R541.61[医药卫生—心血管疾病]