Burri Haran, Sunthorn Henri, Shah Dipen, Lerch René
Cardiology Service, University Hospital of Geneva, Geneva, Switzerland.
Pacing Clin Electrophysiol. 2006 Dec;29(12):1416-25. doi: 10.1111/j.1540-8159.2006.00557.x.
Cardiac resynchronization therapy may lead to remarkable improvement in clinical status in selected patients with heart failure. However, approximately 20-30% of patients may not respond to this treatment. One of the reasons for this may be suboptimal programming of the device, which has particular considerations as compared to standard pacemakers. Hemodynamic response to pacing may be affected by timing of the atrioventricular (AV) interval, affecting synchronicity of atrial and ventricular contraction. In addition current biventricular devices have separate right and left ventricular channels that allow programming of an interventricular (VV) interval with right or left ventricular preexcitation. This article focuses on the parameters that may be optimized for biventricular pacing, and reviews the different techniques currently available for this application, with special emphasis paid to echocardiography.
心脏再同步治疗可能会使部分心力衰竭患者的临床状况得到显著改善。然而，约20% - 30%的患者可能对此治疗无反应。其中一个原因可能是设备程控欠佳，与标准起搏器相比，这有一些特殊考量。起搏的血流动力学反应可能受房室（AV）间期的影响，进而影响心房和心室收缩的同步性。此外，目前的双心室设备有独立的右心室和左心室通道，可通过右心室或左心室预激来程控心室间（VV）间期。本文重点关注双心室起搏可优化的参数，并综述目前用于该应用的不同技术，特别强调了超声心动图。
