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Cardiac resynchronization therapy: Dire need for targeted left ventricular lead placement and optimal device programming

机译:心脏再同步治疗:迫切需要针对性的左心室导线放置和最佳的设备编程

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摘要

Cardiac resynchronization therapy (CRT) effected via biventricular pacing has been established as prime therapy for heart failure patients of New York Heart Association functional class II, III and ambulatory IV, reduced left ventricular (LV) function, and a widened QRS complex. CRT has been shown to improve symptoms, LV function, hospitalization rates, and survival. In order to maximize the benefit from CRT and reduce the number of non-responders, consideration should be given to target the optimal site for LV lead implantation away from myocardial scar and close to the latest LV site activation; and also to appropriately program the device paying particular attention to optimal atrioventricular and interventricular intervals. We herein review current data related to both optimal LV lead placement and device programming and their effects on CRT clinical outcomes.
机译:通过双心室起搏进行的心脏再同步治疗(CRT)已被确立为纽约心脏协会功能性II,III和门诊IV级,左心室(LV)功能降低和QRS增宽加宽的心力衰竭患者的主要治疗方法。 CRT已显示可改善症状,LV功能,住院率和生存率。为了最大程度地受益于CRT并减少无反应者的数量,应考虑将LV导线植入的最佳部位定位为远离心肌疤痕并接近最新的LV部位激活;并适当地对设备进行编程,尤其要注意最佳的房室间隔和心室间隔。在此,我们回顾了与最佳LV导线放置和设备编程有关的当前数据,以及它们对CRT临床结果的影响。

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