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难治性充血性心力衰竭的心脏再同步化治疗临床应用与中远期疗效体会

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摘要 目的:观察双心室同步起搏治疗难治性充血性心力衰竭患者的治疗效果,探讨多部位起搏治疗心力衰竭的临床经验。方法:对16例难治性充血性心力衰竭(既12例原发病为扩张性心肌病及4例原发病为缺血性心肌病的难治性心力衰竭)患者行双室再同步起搏治疗,观察术中、术后6个月、12个月、18个月、24个月左室电极的起搏参数,以及术前、术后7天、术后6个月、12个月、18个月、24个月的QRs波时限、左室射血分数、左室舒张末内径、二尖瓣反流量、心胸比例、临床症状变化。结果:随访两年,患者右心房、右心室电极、左室电极的起搏阈值、阻抗及感知各参数值稳定,起搏功能良好;与术前相比,术后6个月心功能及其他指标明显改善,且随着时间的延长改善持续。结论:心室再同步化起搏是治疗顽固性心衰伴室间传导异常的有效新方法,可改善难治性充血性心力衰竭患者的血流动力学,心功能指标和心衰症状;左室电极植入成功率高,性能稳定、安全可靠。
出处 《新疆医学》 2009年第3期21-25,共5页 Xinjiang Medical Journal
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