Braunschweig F, Linde C, Gadler F, Rydén L
Department of Cardiology, Karolinska Hospital, S-117 76 Stockholm, Sweden.
Eur J Heart Fail. 2000 Dec;2(4):399-406. doi: 10.1016/s1388-9842(00)00113-6.
The health care costs for heart failure are substantial. Studies indicate that hospital treatment constitutes 65-75% of these. The aim of this study was to assess total and heart failure related hospital days as well as safety and efficacy of biventricular pacing in 16 patients with severe heart failure and delayed intraventricular conduction (QRS duration >150 ms). They were implanted with a biventricular pacemaker and followed by NYHA class, 6-min walk test and quality of life for a mean of 291+/-76 days. Total number of hospital days and the need for hospitalisations were monitored. Thirteen responders improved by at least one functional class. After 6 months of pacing the 6-min walk test improved from 375+/-83 m to 437+/-73 m (P<0.001) and Minnesota Living with Heart Failure quality of life score from 41+/-19 to 24+/-17 (P<0.001) compared to baseline. The need for hospital care decreased significantly after biventricular pacing. The total number of hospital days in all patients was 253 the year before compared to 45 the year after biventricular pacing (P<0.01). For heart failure related hospital days the corresponding figures were 183 and 39 days, respectively (P<0.01). Biventricular pacing improved 13/16 patients with severe heart failure and wide QRS complexes in this open study. The improvement resulted in a reduced need for hospital care.
心力衰竭的医疗费用相当可观。研究表明，医院治疗占这些费用的65 - 75%。本研究的目的是评估16例严重心力衰竭且室内传导延迟（QRS波时限>150毫秒）患者的总住院天数和与心力衰竭相关的住院天数，以及双心室起搏的安全性和有效性。他们植入了双心室起搏器，并随访纽约心脏协会（NYHA）心功能分级、6分钟步行试验和生活质量，平均随访291±76天。监测总住院天数和住院需求。13例反应者至少改善了一个功能级别。起搏6个月后，6分钟步行试验从375±83米提高到437±73米（P<0.001），与基线相比，明尼苏达心力衰竭生活质量评分从41±19降至24±17（P<0.001）。双心室起搏后住院护理需求显著减少。所有患者在双心室起搏前一年的总住院天数为253天，起搏后一年为45天（P<0.01）。与心力衰竭相关的住院天数相应数字分别为183天和39天（P<0.01）。在这项开放性研究中，双心室起搏改善了16例严重心力衰竭且QRS波增宽患者中的13例。这种改善导致住院护理需求减少。
