Balmain Sean, McDonald Michael A
Division of Cardiology, University Health Network and Mount Sinai Hospital, University of Toronto, 600 University Avenue, Mount Sinai Hospital, Toronto, Ontario, Canada.
Expert Rev Cardiovasc Ther. 2011 Sep;9(9):1147-53. doi: 10.1586/erc.11.122.
A new era is emerging in the field of complex pacing as a treatment for heart failure. Cardiac resynchronization therapy (CRT) is already established as an effective therapy to improve mortality and functional capacity in patients with moderate-severe heart failure, left ventricular systolic impairment and conduction delay (prolonged QRS duration on surface ECG). Recent evidence has demonstrated that CRT is also an effective treatment for patients with mild heart failure. As the indications for CRT expand, cardiologists face the exciting prospect of exploring where pacemaker technology can help improve patient outcomes across the entire heart failure disease continuum. Enthusiasm for future application needs to be tempered with the practicalities of delivering safe and effective care within the confines of finite healthcare resources.
作为治疗心力衰竭的一种方法，复杂起搏领域正在开启一个新时代。心脏再同步治疗（CRT）已被确立为一种有效疗法，可改善中重度心力衰竭、左心室收缩功能障碍和传导延迟（体表心电图QRS时限延长）患者的死亡率和功能能力。最近的证据表明，CRT对轻度心力衰竭患者也是一种有效治疗方法。随着CRT适应症的扩大，心脏病专家面临着一个令人兴奋的前景，即探索起搏器技术在整个心力衰竭疾病过程中何处能够帮助改善患者预后。对于未来应用的热情需要与在有限医疗资源范围内提供安全有效治疗的实际情况相协调。
