左心室辅助装置后双心室起搏的急性血液动力学效应。
Acute Hemodynamic Effects of Biventricular Pacing After Left Ventricular Assist Device.
机构信息
Division of Cardiovascular Disease, Department of Medicine, University of Alabama, Birmingham, Alabama.
Division of Cardiovascular Disease, Department of Medicine, University of Alabama, Birmingham, Alabama.
出版信息
J Card Fail. 2018 Oct;24(10):716-718. doi: 10.1016/j.cardfail.2018.09.008. Epub 2018 Sep 21.
BACKGROUND
Despite cardiac resynchronization therapy (CRT), some patients with heart failure progress and undergo left ventricular assist device (LVAD) implantation. Management of CRT after LVAD implantation has not been well studied. The purpose of this study was to determine whether RV pacing or biventricular pacing measurably affects acute hemodynamics in patients with an LVAD and a CRT device.
METHODS AND RESULTS
Seven patients with CRT and LVAD underwent right heart catheterization. Pressures and oximetry were measured and LVAD parameters were recorded during 3 different conditions: RV pacing alone, biventricular pacing, and intrinsic atrioventricular conduction. Paired t tests were used to evaluate changes within subjects. There were no significant changes in right atrial pressure, pulmonary arterial pressures, pulmonary capillary wedge pressure, cardiac index, or any LVAD parameter (P > .05).
CONCLUSIONS
Our data suggest that CRT probably has no acute hemodynamic effect in patients with LVADs, but further study is needed.
背景
尽管进行了心脏再同步治疗（CRT），但一些心力衰竭患者仍会进展并接受左心室辅助装置（LVAD）植入。LVAD 植入后 CRT 的管理尚未得到充分研究。本研究旨在确定 RV 起搏或双心室起搏是否可在具有 LVAD 和 CRT 装置的患者中对急性血液动力学产生可测量的影响。
方法和结果
7 例 CRT 和 LVAD 患者接受了右心导管检查。在 3 种不同条件下测量压力和血氧饱和度，并记录 LVAD 参数：RV 起搏、双心室起搏和固有房室传导。使用配对 t 检验评估受试者内的变化。右心房压、肺动脉压、肺毛细血管楔压、心指数或任何 LVAD 参数均无显著变化（P >.05）。
结论
我们的数据表明，CRT 可能对 LVAD 患者没有急性血液动力学影响，但需要进一步研究。
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