• 主题
高级搜索  >
历史搜索 清空历史
首页> 中文期刊> 《浙江临床医学》 >心脏再同步化治疗后期阶段植入心脏复律除颤器的必要性

心脏再同步化治疗后期阶段植入心脏复律除颤器的必要性

         
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

目的 探讨心脏复律除颤器(ICD)在心脏再同步化治疗有反应患者后期阶段预防性植入的必要性.方法 回顾性分析CRT-D/CRT植入前后超声随访记录,包括左房内径大小(LAD)、左室收缩末内径(LVESD)、左室舒张末期内径(LVEDD)、左室射血分数(LVEF);回顾CRT-D/CRT二者随访的心律失常发生情况及CRT-D放电治疗事件;二者5年生存率.结果(1)80例CRT/CRT-D植入后有反应的患者(CRT44例,CRT-D36例),平均随访时间(6±2.8)年,两组治疗有反应患者LAD、LVEDD、LVESD数值均较植入前缩小,左室射血分数(LVEF)较植入前升高,但两组治疗有反应患者心脏结构及射血分数在植入后4年与植入后1年的变化值比较差异无统计学意义(P>0.05);(2)CRT-D/CRT植入后?1年内均有新发心律失常事件,两组比较差异无统计学意义(P>0.05),随访4年后二者新发生恶性心律失常事件发生率较低;(3)CRT-D治疗组患者5年生存率为86.1%,CRT治疗组5年生存率为84.1%,两组比较差异无统计学意义(P=0.748).结论? CRT能改善部分心力衰竭患者心功能、逆转心室重构.随着治疗的持续,CRT能逐步减少有反应患者心律失常的发生,在治疗后期阶段可能不需预防性植入ICD.%Objective To?compare?the?efficacy?of?CRT-D/CRT,and?to?investigate?the?necessity?of?implantable?cardioverter?defibrillator (ICD)in?patients?with?reactions?undergoing?cardiac?resynchronization?therapy?at?the?later?stage.?Methods Ultrasonic?follow-up?records?before?and?after?CRT-D/CRT?implantation?were?retrospectively?analyzed,including?left?atrial?diameter(LAD),left?ventricular?end-systolic?diameter (LVESD),left?ventricular?end-diastolic?diameter(LVEDD)and?left?ventricular?ejection?fraction(LVEF).?Arrhythmia?events?of?CRT-D/CRT?and?discharge?events?of?CRT-D?in?the?cardiac?pacemaker?clinic?and?five-year?survival?rate?of?CRT-D/CRT?were?reviewed. Results (1)A?total?of?80?patients?with?reactions?after?CRT/CRT-D?implantation(CRT,n=44;CRT-D,n=36)were?included?in?this?study?from?ShaoXing?Hospital?Affiliated?to?China?Medical?University?and?Huadong?Hospital?Affiliated?to?Fudan?University.?Mean?follow-up?time?was?6±2.8?years.?LAD,LVEDD?and?LVESD?in?patients?with?reactions?in?both?treatment?groups?decreased?when?compared?with?those?before?implantation,while?LVEF?increased?than?that?before?implantation.?No?statistically?significant?differences?were?found?in?cardiac?structure?or?ejection?fraction?in?patients?with?reactions?of?both?treatment?groups?at?the?1st?year?and?4th?year?after?implantation(P>0.05);(2)New?arrhythmia?events?were?detected?after?CRT-D/CRT?implantation?within?1?year,with?no?significantly?statistical?differences(P>0.05).?After?4-year?follow-up,the?proportion?of?malignant?arrhythmia?events?was?extremely?low;(3)Five-year?survival?rates?in?the?CRT-D?group?and?CRT?group?were?86.1%?and?84.1%,respectively(P=0.334).?Conclusion CRT?can?improve?partial?heart?function?and?reverse?ventricular?remodeling?in?patients?with?heart?failure.?With?continuous?treatment,CRT?can?gradually?reduce?the?occurrence?of?arrhythmia?in?patients?with?reactions,and?in?the?later?stage?of?treatment,prophylactic?implantation?of?ICD?may?not?be?needed.

著录项

相似文献

  • 中文文献
  • 外文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号