BACKGROUND Cardiac resynchronization therapy(CRT) can be used as an escalated therapy to improve heart function in patients with cardiac dysfunction due to long-term right ventricular pacing. However, guidelines are o...BACKGROUND Cardiac resynchronization therapy(CRT) can be used as an escalated therapy to improve heart function in patients with cardiac dysfunction due to long-term right ventricular pacing. However, guidelines are only targeted at adults. CRT is rarely used in children.CASE SUMMARY This case aimed to implement biventricular pacing in one child with heart failure who had a left ventricular ejection fraction < 35% at 4 years after implantation of an atrioventricular sequential pacemaker due to atrioventricular block.Postoperatively, echocardiography showed atrial sensing ventricular pacing and QRS wave duration of 120-130 ms, and cardiac function significantly improved after upgrading pacemaker.CONCLUSION Patients whose cardiac function is deteriorated to a level to upgrade to CRT should be upgraded to reverse myocardial remodeling as soon as possible.展开更多
目的:介绍自动阈值夺获(Autocapture)自动模式转换(Automatic Mode Switch)双腔起搏器测试及随访。方法:20例患者,肥厚梗阻型心肌病1例,Ⅲ度房室传导阻滞(AVB)9例,病窦10例其中阵发房颤(AF)5例。植入Affinity DC 5230起搏器,植入手术同...目的:介绍自动阈值夺获(Autocapture)自动模式转换(Automatic Mode Switch)双腔起搏器测试及随访。方法:20例患者,肥厚梗阻型心肌病1例,Ⅲ度房室传导阻滞(AVB)9例,病窦10例其中阵发房颤(AF)5例。植入Affinity DC 5230起搏器,植入手术同普通DDD,术中及随访测试起搏阈值,阻抗,输出电压,刺激除极波(ER),极化电位。结果:除1例肥厚梗阻型心肌病外,余19例患者自动阈值夺获(其中5例阵发AF患者开启自动模式转换),术中或术后3天均开启,随访6个月工作良好。结论:具有自动阈值夺获及自动模式转换功能的双腔起搏器安全节能,使用寿命长,模式自动转换功能尤适用于伴阵发AF的慢-快综合征患者。展开更多
本文观察26例起搏心率为60～120次/分心室起搏病人血流动力变化及11例心室起搏病人在起搏心率为70～120次/分时核素心血池显象测定的左室 EF 变化.结果表明①大部份病人CO 与起搏心率增加的关系为抛物线曲线规律,SV 与起搏心率增加则为...本文观察26例起搏心率为60～120次/分心室起搏病人血流动力变化及11例心室起搏病人在起搏心率为70～120次/分时核素心血池显象测定的左室 EF 变化.结果表明①大部份病人CO 与起搏心率增加的关系为抛物线曲线规律,SV 与起搏心率增加则为负相关;②最佳起搏心率个体差异很大,在设置频率响应起搏器上限心率时应实测后再选定;③心室起搏后 CO 下降者日后安装 VVI 起搏器易出现起搏器综合征;④起搏心率变化引起的 EF 变化未能客观地反映心脏收缩功能的变化。展开更多
基金Supported by The Clinical Research Center Project of Department of Science and Technology of Guizhou Province,No.(2016)410 and No.(2017)5405
文摘BACKGROUND Cardiac resynchronization therapy(CRT) can be used as an escalated therapy to improve heart function in patients with cardiac dysfunction due to long-term right ventricular pacing. However, guidelines are only targeted at adults. CRT is rarely used in children.CASE SUMMARY This case aimed to implement biventricular pacing in one child with heart failure who had a left ventricular ejection fraction < 35% at 4 years after implantation of an atrioventricular sequential pacemaker due to atrioventricular block.Postoperatively, echocardiography showed atrial sensing ventricular pacing and QRS wave duration of 120-130 ms, and cardiac function significantly improved after upgrading pacemaker.CONCLUSION Patients whose cardiac function is deteriorated to a level to upgrade to CRT should be upgraded to reverse myocardial remodeling as soon as possible.
文摘目的:介绍自动阈值夺获(Autocapture)自动模式转换(Automatic Mode Switch)双腔起搏器测试及随访。方法:20例患者,肥厚梗阻型心肌病1例,Ⅲ度房室传导阻滞(AVB)9例,病窦10例其中阵发房颤(AF)5例。植入Affinity DC 5230起搏器,植入手术同普通DDD,术中及随访测试起搏阈值,阻抗,输出电压,刺激除极波(ER),极化电位。结果:除1例肥厚梗阻型心肌病外,余19例患者自动阈值夺获(其中5例阵发AF患者开启自动模式转换),术中或术后3天均开启,随访6个月工作良好。结论:具有自动阈值夺获及自动模式转换功能的双腔起搏器安全节能,使用寿命长,模式自动转换功能尤适用于伴阵发AF的慢-快综合征患者。
文摘本文观察26例起搏心率为60～120次/分心室起搏病人血流动力变化及11例心室起搏病人在起搏心率为70～120次/分时核素心血池显象测定的左室 EF 变化.结果表明①大部份病人CO 与起搏心率增加的关系为抛物线曲线规律,SV 与起搏心率增加则为负相关;②最佳起搏心率个体差异很大,在设置频率响应起搏器上限心率时应实测后再选定;③心室起搏后 CO 下降者日后安装 VVI 起搏器易出现起搏器综合征;④起搏心率变化引起的 EF 变化未能客观地反映心脏收缩功能的变化。
