Allison John D, Biton Yitschak, Mela Theofanie
The Demoulas Center for Cardiac Arrhythmias, Department of Medicine, Massachusetts General Hospital, Boston, MA, USA.
Cardiac Arrhythmia Service, Hadasssah Medical Center and Hebrew University in Jerusalem Medical School, Jerusalem, Israel.
J Innov Card Rhythm Manag. 2022 May 15;13(5):4994-5003. doi: 10.19102/icrm.2022.130503. eCollection 2022 May.
Cardiac resynchronization therapy (CRT) is a well-established treatment modality for ambulatory patients with heart failure (HF) who have prolonged QRS, left bundle branch block, reduced left ventricular (LV) ejection fraction, and New York Heart Association class II-IV. CRT has been shown to induce reverse LV remodeling and improve HF symptoms and clinical outcomes. About one-third of CRT recipients are considered non-responders. Patient selection, LV lead location, LV lead selection, multipoint pacing, and optimization of the atrioventricular and ventriculo-ventricular intervals were all shown to be associated with a better CRT response rate. Herein, we review the determinants of CRT response.
心脏再同步治疗(CRT)是一种成熟的治疗方式,适用于患有心力衰竭(HF)、QRS波增宽、左束支传导阻滞、左心室(LV)射血分数降低且纽约心脏协会心功能分级为II-IV级的门诊患者。CRT已被证明可诱导左心室逆向重构,并改善心力衰竭症状和临床结局。约三分之一接受CRT治疗的患者被认为无反应。患者选择、左心室导线位置、左心室导线选择、多点起搏以及房室和心室间间期的优化均被证明与更高的CRT反应率相关。在此,我们综述了CRT反应的决定因素。