Potential benefit of biventricular pacing in patients with congestive heart failure and ventricular tachyarrhythmia.
Potential benefit of biventricular pacing in patients with congestive heart failure and ventricular tachyarrhythmia.
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双心室起搏对充血性心力衰竭和室性快速心律失常患者的潜在益处。
DOI：
10.1016/s0002-9149(98)01016-9
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发表时间：
1999
期刊：
影响因子：
--
通讯作者：
P. Hanrath
中科院分区：
文献类型：
--
作者：
C. Stellbrink;A. Auricchio;B. Diem;O. Breithardt;M. Kloss;F. Schöndube;Helmut Klein;B. Messmer;P. Hanrath
充血性心力衰竭（CHF）的治疗目的是缓解症状，降低猝死和泵衰竭的死亡率。植入式心律转复除颤器（ICD）在预防猝死方面非常有效，但尚未显示对晚期CHF的死亡率有任何益处。双心室起搏可能会改善某些CHF患者的功能。因此，具有除颤功能的双心室起搏器可能是晚期CHF患者的理想选择。我们回顾性分析了384例患者（年龄59 ± 12岁，322例男性和62例女性）的数据，包括纽约心脏协会（NYHA）CHF分级、平均QRS持续时间、平均PR间期、QRS >120 msec的存在和ICD植入时房颤的发生率。根据双心室起搏研究的合格标准，我们分析了有多少患者可能从双心室起搏中受益。CHF患者年龄较大（NYHA III级：60.9 ± 9.7，II级：61.3 ± 10 vs I级：50.8 ± 13.6年，p <0.001），晚期CHF患者的平均QRS时限较长（NYHA III级：127.8 ± 30 msec; II级：119.4 ± 27.7 msec; 0-I级：103.9 ± 17.7 msec，p <0.001，方差分析）以及平均PR间期（NYHA III级189.9 ± 33.5 msec; II级176.1 ± 29.3 msec; 0-I级162.7 ± 45.9 msec，p <0.001，方差分析）。与0-I级（16.9%）和II级患者（14.1%，p = 0.043，卡方检验）相比，III级患者（25.5%）的房颤发生率更高。如果NYHA III级患者被视为候选者，则共有28例患者（7.3%）符合双心室起搏的合格标准，如果纳入NYHA II级CHF且射血分数≤30%的患者，则共有48例患者（12.5%）符合双心室起搏的合格标准。因此，双心室起搏可能为大部分有室性快速性心律失常风险的CHF患者提供一种有前景的治疗方法。
Treatment of congestive heart failure (CHF) aims for symptomatic relief and reduction of mortality both from sudden death and pump failure. The implantable cardioverter defibrillator (ICD) is highly effective in the prevention of sudden death, but no mortality benefit in advanced CHF has yet been shown. Biventricular pacing may lead to functional improvement in selected patients with CHF. Thus, a biventricular pacemaker with defibrillation capabilities may be ideal for patients with advanced CHF. We retrospectively analyzed the data from 384 patients (age 59 ± 12 years, 322 male and 62 female) with regard to New York Heart Association (NYHA) CHF class, mean QRS duration, mean PR interval, presence of a QRS >120 msec and incidence of atrial fibrillation at the time of ICD implantation. Based on eligibility criteria from studies in biventricular pacing, we analyzed how many patients may benefit from biventricular pacing. Patients with CHF were older (NYHA class III: 60.9 ± 9.7, class II: 61.3 ± 10 versus class I: 50.8 ± 13.6 years, p <0.001 each) and mean QRS duration was longer with advanced CHF (NYHA class III 127.8 ± 30 msec; class II 119.4 ± 27.7 msec; class 0–I: 103.9 ± 17.7 msec, p <0.001, analysis of variance) as was the mean PR interval (NYHA class III 189.9 ± 33.5 msec; class II 176.1 ± 29.3 msec; class 0–I 162.7 ± 45.9 msec, p <0.001, analysis of variance). The incidence of atrial fibrillation was higher in class III (25.5%) compared with class 0–I (16.9%) and class II patients (14.1%, p = 0.043, chi-square test). A total of 28 patients (7.3%) fulfilled eligibility criteria for biventricular pacing if NYHA class III patients were considered candidates and 48 (12.5%) if patients with NYHA II CHF and ejection fraction ≤30% were included. Thus, biventricular pacing may offer a promising therapeutic approach for a significant proportion of patients with CHF at risk for ventricular tachyarrhythmia.
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DOI：
10.1016/0735-1097(93)90455-a
发表时间：
1993-10-01
影响因子：
24
作者：
HO, KKL;PINSKY, JL;LEVY, D
通讯作者：
LEVY, D
对从近乎致命的室性心律失常中复苏的患者进行抗心律失常药物治疗与植入式除颤器的比较。
DOI：
10.1056/nejm199711273372202
发表时间：
1997
期刊：
The New England journal of medicine
影响因子：
--
作者：
AntiarrhythmicsversusImplantableDefibrillators(AVID)Investigators
通讯作者：
AntiarrhythmicsversusImplantableDefibrillators(AVID)Investigators
对 15 名自发性心室颤动患者的动态心电图进行分析，特别参考之前的心律失常事件。
影响因子：
24
作者：
Pratt,CM;Francis,MJ;Luck,JC;Wyndham,CR;Miller,RR;Quinones,MA
通讯作者：
Quinones,MA
当“心源性猝死”不再那么突然时：自动植入式除颤器的教训。
影响因子：
4.8
作者：
Guarnieri,T;Levine,JH;Griffith,LS;Veltri,EP
通讯作者：
Veltri,EP