双心室起搏的临床疗效观察  

Effect of biventricular pacing clinical application.

作　　者：沈法荣[1] 黄抒伟[1] 沈亚平[1] 凌峰[1] 陈建明[1] 金宏义[1] 

机构地区：[1]浙江医院心内科,310013

出　　处：《心脑血管病防治》2001年第3期5-7,共3页CARDIO-CEREBROVASCULAR DISEASE PREVENTION AND TREATMENT

摘　　要：目的　探讨缺血性或扩张型心肌病合并充血性心力衰竭行永久性双心室起搏治疗的临床效果。方法　对 1 0例缺血性或扩张型心肌病合并难治性心力衰竭和左束支阻滞患者 ,常规植入右心室起搏导线的同时植入冠状静脉窦电极导线于左室侧静脉、心大或心中静脉 ,行双心室同步起搏 (其中 2例为四腔起搏 )。通过临床观察、超声心动图测定及 6分钟平地行走评定对心功能的影响。结果　在充血性心力衰竭合并左束支阻滞患者植入冠状静脉窦电极导线行双心室起搏 ,产生较窄 QRS波 ,临床心功能从 ～ 级提高至 ～ 级 ( NYHA) ,同时使二尖瓣返流减少 ,射血分数提高 ,左室舒张末期内径缩小 ,6分钟平地行走距离比术前明显提高。结论　双心室起搏对难治性心力衰竭可能有辅助治疗作用。Objective To observe the effect of biventricular pacing clinical application to treat chronic refractory congestive heat failure due to ischaemic or dilated cardiomyopathy. Methods Ten patients,who suffered from ischemic or dilated cardiomyopathy with refractory heart failure with left bundle branch block,were implanted with coronary sinus (CS) leads into the lateral branch of cardiac vein (4 cases),the great cardiac vein (5 cases) and the middle cardiac vein (1 case),and right ventricular leads into right ventricular apex.These Leads were composed of biventricular pacing (2 cases for four chamber pacing).These patients are now being followed at 6～22(15±5)months.The clinical NYHA classfication,echocardiography,QRS width,left ventricular ejection and exercise toler ance were assessed. Results The bivetricular pacing showed a narrow QRS wave.The NYHA classification was significantly improved from Ⅲ～Ⅳ to Ⅱ～Ⅲ class.Echocardiongraphy showed a decrese in diameter of left ventricular distolicend.Left ventricular ejection fraction and exercise tolerance displayed a significant increase.Mitral regurgitation exhibited a significant decrease. Conclusions Biventricular pacing might potentially improve the heart function with refractory congestive heart failure with left bundle branch block.

关 键 词：心力衰竭 双心室起搏 临床疗效观察 

分 类 号：R541.7[医药卫生—心血管疾病]