Hedrich Olaf, Weinstock Jonathan, Link Mark, Homoud Munther, Estes Mark
New England Cardiac Arrhythmia Center, Division of Cardiology, Tufts-New England Medical Center, Boston, Massachusetts, USA.
Rev Cardiovasc Med. 2005;6 Suppl 2:S21-31.
Despite considerable progress in heart failure management with pharmacologic agents, measures to bring about significant improvements in morbidity and mortality are still needed. Cardiac resynchronization therapy (CRT) is a means to enhance myocardial function by stimulating the failing left ventricle at or near the time of right ventricular activation to synchronize ventricular depolarization. Current data from randomized, controlled trials suggest that CRT benefits patients with moderate to severe heart failure and have shown that this therapy significantly reduces mortality and hospital admissions in this group. In addition to CRT, implantable cardioverter-defibrillators have been evaluated in heart failure patients with significantly reduced left ventricular function and have been shown to reduce mortality from sudden cardiac death. This article summarizes recent device trials and discusses how best to apply their results to clinical practice.
尽管在心力衰竭药物治疗方面取得了显著进展，但仍需要采取措施以显著改善发病率和死亡率。心脏再同步治疗（CRT）是一种通过在右心室激活时或接近该时间刺激衰竭的左心室来同步心室去极化，从而增强心肌功能的方法。来自随机对照试验的当前数据表明，CRT使中度至重度心力衰竭患者受益，并已表明该疗法显著降低了该组患者的死亡率和住院率。除了CRT，植入式心脏复律除颤器已在左心室功能显著降低的心力衰竭患者中进行了评估，并已表明可降低心源性猝死的死亡率。本文总结了近期的器械试验，并讨论了如何最好地将其结果应用于临床实践。
