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首页> 外文期刊>Annals of thoracic and cardiovascular surgery: official journal of the Association of Thoracic and Cardiovascular Surgeons of Asia >Clinical evaluation of combination therapy for biventricular pacing after cardiac surgery in patients with intractable heart failure.
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Clinical evaluation of combination therapy for biventricular pacing after cardiac surgery in patients with intractable heart failure.

机译：顽固性心力衰竭患者心脏手术后双室起搏联合治疗的临床评价。

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We examined the effectiveness of combination therapy for biventricular pacing after cardiac surgery. We performed biventricular pacing in seven patients until April 2003. The diagnosis of the patients was ischemic cardiomyopathy (ICM) in four patients and dilated cardiomyopathy (DCM) in three patients. The implantation method of biventricular pacing was performed with a myocardial electrode through a median sternotomy. DDD-R and SSI-R were used to perform biventricular pacing. A Y-adapter was connected to a generator so that the 2 leads could be implanted in both the right ventricles (RV) and left ventricles (LV). The clinical symptoms were New York Heart Association (NYHA) classification of 3.7+/-0.3 preoperatively and 1.8+/-0.6 postoperatively, showing a significant improvement (p<0.001). The cardiac index (CI) was 1.9+/-0.2 L/min/m2 preoperatively and 3.0+/-0.6 L/min/m2 postoperatively (p<0.05). The pulmonary capillary wedge pressure (PCWP) was 19.5+/-2.6 mmHg preoperatively and 13.6+/-2.0 mmHg postoperatively, showing a significant improvement (p<0.05). The intracardiac potential and threshold values were: left atrium 1.9+/-1.0 mV, threshold value (PW: 0.45 msec) 2.1+/-0.6 V, LV 4.9+/-4.23 mV, threshold value (PW: 0.45 msec) 2.2+/-1.51 V, and RV 3.6+/-0.9 V, threshold value (PW: 0.45 msec) 2.0+/-0.7 V. The LV and RV threshold values were high. The QRS interval improved from 158.4+/-18.0 msec preoperatively to 110+/-13.4 msec postoperatively, showing a significant reduction. This combination therapy when compared to the use of the biventricular pacing method used at the current time, does have the risks of cardiac surgery, but the clinical symptoms and hemodynamic performance improvement are great.
机译：我们检查了心脏手术后联合治疗对双心室起搏的有效性。直到2003年4月，我们对7例患者进行了双室起搏。诊断为4例患者为缺血性心肌病（ICM），3例为扩张型心肌病（DCM）。双室起搏的植入方法是通过正中胸骨切开术使用心肌电极进行的。 DDD-R和SSI-R用于执行双心室起搏。将Y型适配器连接到发生器，以便可以将2条导线植入右心室（RV）和左心室（LV）中。临床症状为术前为3.7 +/- 0.3，术后为1.8 +/- 0.6的纽约心脏协会（NYHA）分类，显示出显着改善（p <0.001）。术前心脏指数（CI）为1.9 +/- 0.2 L / min / m2，术后为3.0 +/- 0.6 L / min / m2（p <0.05）。术前肺毛细血管楔压（PCWP）为19.5 +/- 2.6 mmHg，术后为13.6 +/- 2.0 mmHg，显示出显着改善（p <0.05）。心内电位和阈值是：左心房1.9 +/- 1.0 mV，阈值（PW：0.45毫秒）2.1 +/- 0.6 V，LV 4.9 +/- 4.23毫伏，阈值（PW：0.45毫秒）2.2+ /-1.51 V和RV 3.6 +/- 0.9 V，阈值（PW：0.45毫秒）2.0 +/- 0.7V。LV和RV阈值较高。 QRS间隔从术前的158.4 +/- 18.0毫秒提高到术后的110 +/- 13.4毫秒，显示出明显的减少。与目前使用的双心室起搏方法相比，这种联合疗法确实具有心脏手术的风险，但是临床症状和血液动力学性能的改善很大。

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