识别心脏再同步治疗无反应者的心电图线索
Electrocardiographic clues to identify nonresponders to cardiac resynchronization therapy.
作者信息
El Sabbagh Firas H, Guzon Osler Jay J, Alpert Martin A, Flaker Greg C
机构信息
Division of Cardiovascular Medicine, University of Missouri-Columbia, Five Hospital Drive, Columbia, MO 65212, USA.
出版信息
Ann Noninvasive Electrocardiol. 2010 Oct;15(4):369-77. doi: 10.1111/j.1542-474X.2010.00393.x.
BACKGROUND
The aim of cardiac resynchronization therapy (CRT) is to restore myocardial electromechanical synchrony. Achieving this in patients with chronic severe heart failure due to poor left ventricular (LV) systolic function and cardiac dyssynchrony on optimal medical therapy, is associated with improved clinical performance and outcomes. Up to one-third of patients undergoing CRT do not benefit from implantation. Ensuring LV capture is essential and can be at times difficult to confirm.
METHODS
Described herein, are six patients who underwent biventricular pacemaker implantation but failed to experience an improvement in LV systolic function or functional capacity.
RESULTS
In each case, the 12-lead electrocardiogram (ECG) was helpful in unmasking loss of LV capture in patients who were presumed to have biventricular pacing.
CONCLUSIONS
Despite the technical wizardry behind CRT and patient system analyzers, the surface ECG should continue to be an invaluable tool for evaluating patients who have undergone CRT.
背景
心脏再同步治疗（CRT）的目的是恢复心肌电机械同步性。对于因左心室（LV）收缩功能差和心脏不同步而接受最佳药物治疗的慢性重度心力衰竭患者，实现这一点与改善临床性能和预后相关。接受CRT治疗的患者中，高达三分之一未能从植入治疗中获益。确保左心室夺获至关重要，有时难以确认。
方法
本文描述了6例接受双心室起搏器植入但左心室收缩功能或功能能力未改善的患者。
结果
在每种情况下，12导联心电图（ECG）有助于揭示推测为双心室起搏患者的左心室夺获丧失情况。
结论
尽管CRT和患者系统分析仪背后有精湛技术，但体表心电图仍应是评估接受CRT治疗患者的宝贵工具。
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