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慢性心力衰竭患者的心脏再同步治疗

Cardiac resynchronisation therapy in patients with chronic heart failure.

作者信息

Lalani Gautam G, Birgersdotter-Green Ulrika

机构信息

University of California, San Diego, California, USA.

出版信息

Heart. 2015 Jul;101(13):1008-14. doi: 10.1136/heartjnl-2014-306835. Epub 2015 Apr 16.

Abstract

Cardiac resynchronisation therapy (CRT) is common treatment for congestive heart failure (HF) with decreased LV function and wide QRS complex. Its foundations are set in the understanding of the pathophysiology of ventricular dyssynchrony. Over the last several decades, CRT has evolved through changes in implantation techniques, device and lead design, imaging modalities and our growing clinical experience. This review article will discuss the vast clinical experience that has led to current guidelines recommendations for CRT in patients with mild-to-severe HF. In addition, the article will also discuss recent evidence of benefits of CRT in patients beyond the guidelines. The article will also address the issue of non-responders, optimisation of CRT, postimplant evaluation and remote monitoring.

摘要

心脏再同步治疗(CRT)是治疗左心室功能减退和QRS波群增宽的充血性心力衰竭(HF)的常用方法。其基础在于对心室不同步病理生理学的理解。在过去几十年中,CRT随着植入技术、设备和导线设计、成像方式的变化以及我们不断增长的临床经验而不断发展。这篇综述文章将讨论大量临床经验,这些经验促成了目前针对轻至重度HF患者CRT的指南推荐。此外,本文还将讨论CRT在指南范围之外患者中的近期获益证据。本文还将探讨无反应者的问题、CRT的优化、植入后评估和远程监测。

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