Yu Shan, Wu Qiang, Chen Bao-Lin, An Ya-Ping, Bu Jie, Zhou Song, Wang Yong-Mei
Department of Cardiology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China.
Department of Radiology, Guizhou Provincial People's Hospital, Guiyang 550002, Guizhou Province, China.
World J Clin Cases. 2019 Feb 6;7(3):396-404. doi: 10.12998/wjcc.v7.i3.396.
Cardiac resynchronization therapy (CRT) can be used as an escalated therapy to improve heart function in patients with cardiac dysfunction due to long-term right ventricular pacing. However, guidelines are only targeted at adults. CRT is rarely used in children.
This case aimed to implement biventricular pacing in one child with heart failure who had a left ventricular ejection fraction < 35% at 4 years after implantation of an atrioventricular sequential pacemaker due to atrioventricular block. Postoperatively, echocardiography showed atrial sensing ventricular pacing and QRS wave duration of 120-130 ms, and cardiac function significantly improved after upgrading pacemaker.
Patients whose cardiac function is deteriorated to a level to upgrade to CRT should be upgraded to reverse myocardial remodeling as soon as possible.
心脏再同步治疗（CRT）可作为一种强化治疗方法，用于改善因长期右心室起搏导致心功能不全患者的心脏功能。然而，相关指南仅针对成年人。CRT在儿童中很少使用。
本病例旨在对一名心力衰竭患儿实施双心室起搏，该患儿因房室传导阻滞植入房室顺序起搏器4年后左心室射血分数<35%。术后，超声心动图显示心房感知心室起搏，QRS波时限为120 - 130毫秒，起搏器升级后心功能显著改善。
心功能恶化至需升级为CRT的患者应尽快升级，以逆转心肌重构。
