Univ Rennes, CHU Rennes, INSERM, LTSI - UMR 1099, F-35000 Rennes, France; Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States of America.
Prog Cardiovasc Dis. 2019 May-Jun;62(3):242-248. doi: 10.1016/j.pcad.2019.04.004. Epub 2019 Apr 17.
Patients with cardiomyopathy and reduced left ventricular (LV) ejection fraction are at risk of heart failure (HF) symptoms and sudden cardiac arrest (SCA). In selected HF patients, cardiac resynchronization therapy (CRT) provides LV reverse remodeling and improves the cellular and molecular function. However controversial results have been published regarding the effect of CRT on the residual ventricular arrhythmia risk. Indeed, the decrease in SCA risk is inconsistent and some factors strongly influence the residual post implantation arrhythmic risk. Conversely, proarrhythmic effect of CRT has been previously described. In this review we aim to describe the relationship between CRT implantation and the SCA risk decrease and discuss the patients who only require cardiac resynchronization therapy-pacemaker and those who need a concomitant implantable cardioverter defibrillator.
患有心肌病和左心室射血分数降低的患者有心力衰竭（HF）症状和心源性猝死（SCA）的风险。在选定的 HF 患者中，心脏再同步治疗（CRT）可提供 LV 逆向重构并改善细胞和分子功能。然而，关于 CRT 对残余室性心律失常风险的影响，已有争议结果发表。事实上，SCA 风险的降低并不一致，一些因素强烈影响残余植入后心律失常的风险。相反，CRT 的致心律失常作用以前已经被描述过。在这篇综述中，我们旨在描述 CRT 植入与 SCA 风险降低之间的关系，并讨论仅需要心脏再同步治疗-起搏器的患者和需要植入式心脏复律除颤器的患者。
