Department of Cardiology and Vascular Diseases, Hôpital Pontchaillou-CHU, Rennes, 35033 France.
Europace. 2009 Nov;11 Suppl 5:v87-92. doi: 10.1093/europace/eup305.
Device therapy for heart failure has a spectacular development during the last 10 years. Patients with chronic heart failure might benefit from electrical therapy with a view to: (i) resynchronize the failing and dyssynchronized heart and improve its mechanical performance or (ii) prevent the risk of sudden death by automatic defibrillation. These two therapies can be applied together with a combined device, the biventricular implantable cardioverter-defibrillator (CRT-D). Today, the proportion of CRT-D devices among all CRT devices implanted around the world is more than 75% and more than 85% in the USA. This review article will try to answer some important questions for clinical practice: is the growing use of CRT-D devices supported by clinical evidence? Is the risk-benefit profile of CRT-D favourable in particular in mildly symptomatic patients?
在过去的 10 年中，心力衰竭的器械治疗取得了显著的发展。慢性心力衰竭患者可能受益于电治疗，以期：（i）使衰竭和不同步的心脏重新同步，改善其机械性能，或（ii）通过自动除颤预防猝死风险。这两种治疗方法可以与联合设备，即双心室植入式心脏复律除颤器（CRT-D）一起应用。如今，全球植入的所有 CRT 设备中，CRT-D 设备的比例超过 75%，在美国超过 85%。本文将尝试回答一些临床实践中的重要问题：CRT-D 设备的广泛应用是否有临床证据支持？CRT-D 的风险效益比在有轻微症状的患者中是否有利？
