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首页> 外文期刊>Research Reports in Clinical Cardiology >Individualized cardiac resynchronization therapy: current status
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Individualized cardiac resynchronization therapy: current status

机译：个体化心脏再同步治疗：现状

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Abstract: Cardiac resynchronization therapy (CRT) has shown a substantial reduction in heart failure patient morbidity and mortality, with improvement in quality of life as well as symptoms. The therapy is, however, limited to approximately 10%–15% of heart failure patients and, typically, 30% do not derive benefit from the device. For optimal outcomes with CRT, the correct selection of patients is of paramount importance. The first parameter is depressed left ventricular systolic function, and the second is a wide QRS complex. Different nuances among clinical trials have rendered guidelines pragmatic and compromising, but also conflicting and confusing. A large proportion of real-life CRTs are implanted in patients where the evidence for benefit is scarce or not present. Further, for optimal benefit, patients require evidence-directed medical therapy at maximal doses, effective placement of ventricular leads, and high biventricular pacing percentages, along with optimized atrioventricular (AV) and interventricular interval device programming. These items, as well as specific clinical characteristics, such as AV block and atrial fibrillation, in the context of CRT indications, are discussed. This review focuses on these issues to guide the clinician through guidelines, with an evidence-based update on the current status of CRT.
机译：摘要：心脏再同步治疗（CRT）已显示心衰患者的发病率和死亡率大大降低，生活质量和症状得到改善。但是，该疗法仅限于约10％–15％的心力衰竭患者，并且通常30％的患者无法从该设备中受益。为了获得CRT的最佳结果，正确选择患者至关重要。第一个参数是抑郁的左心室收缩功能，第二个参数是宽QRS波群。临床试验之间的细微差别使准则变得务实和妥协，但也引起冲突和混乱。现实生活中的CRT大部分都被植入到缺乏或没有获益证据的患者中。此外，为了获得最佳收益，患者需要以最大剂量进行循证医学治疗，有效放置心室导联，高心室起搏百分比以及优化的房室（AV）和心室间隔装置编程。在CRT适应症的背景下，将讨论这些项目以及特定的临床特征，例如房室传导阻滞和心房颤动。这篇综述着重于这些问题，以指导临床医生通过指南，并提供有关CRT当前状态的循证更新。

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