Left Univentricular Pacing by Rate-Adaptive Atrioventricular Delay in Treatment of Chronic Heart Failure.
Left Univentricular Pacing by Rate-Adaptive Atrioventricular Delay in Treatment of Chronic Heart Failure.
复制标题
速率自适应房室延迟左单心室起搏治疗慢性心力衰竭
DOI：
10.12659/msm.904348
复制
发表时间：
2017-08-17
期刊：
影响因子：
--
通讯作者：
Guo T
中科院分区：
文献类型：
--
作者：
Zhao L;Zhao L;Pu L;Hua B;Wang Y;Li S;Li Q;Guo T
背景心脏复律治疗（CRT）是治疗慢性心力衰竭（CHF）的有效方法，但由于CRT是非生理性的，有些患者反应迟钝。本研究应用频率适应性房室延迟（RAAVD）技术跟踪生理性房室延迟，探讨左心室单心室起搏对CRT的影响。材料/方法将符合CRT I级适应证的CHF患者分为RAAVD左单心室起搏组和标准双心室起搏组。评估术前和术后心电图QRS时限、超声心动图指标、生活质量、心功能和年治疗费用。计算RAAVD左心室起搏时V1导联5个心率段S/R比值的标准差（RS/R-SD 5），评价RAAVD跟踪生理AV延迟的准确性。结果RAAVD组左心室单室起搏与标准双室起搏组比较，术后QRS时限明显缩短（137±11 vs. 144±11 ms，P<0.05），AVVTI增加（21.84±2.25 vs20.45 ± 2.12cm，P<0.05），IVMD减小（64.27± 12.29vs71.39 ± 13.64ms，P<0.05），MRA降低（3.09± 1.12vs3.73 ± 1.19cm2，P<0.05），平均年治疗费用（1.30± 0.1vs2.20 ± 0.20万元，P<0.05）。RAAVD组左单心室起搏的RS/R-SD 5与心功能改善呈负相关（r=-0.394，P=0.031）。结论RAAVD左单心室起搏与标准双心室起搏疗效相似，是一种经济、生理上有效的双心室收缩功能重建治疗CHF的方法。
Background Cardiac resynchronization therapy (CRT) is efficacious in the treatment of chronic heart failure (CHF); however, because it is non-physiological, some patients are unresponsive. The present study used rate-adaptive atrioventricular delay (RAAVD) to track the physiological atrioventricular delay and investigated the effects of left univentricular pacing on CRT. Material/Methods Patients with CHF fulfilling the indication of CRT Class I were categorized into a left univentricular pacing by RAAVD group and a standard biventricular pacing group. Preoperative and postoperative electrocardiography QRS duration, echocardiographic indicators, quality of life, cardiac function, and annual treatment cost were estimated. The standard deviation (RS/R-SD5) of the S/R ratio in lead V1 at 5 heart rate segments in the left univentricular pacing by RAAVD was calculated, and the accuracy of RAAVD in tracking the physiological AV delay was evaluated. Results The comparison between the left univentricular pacing by RAAVD group and the standard biventricular pacing group after operation showed a significantly reduced QRS duration (137±11 vs. 144±11 ms, P<0.05), increased AVVTI (21.84±2.25 vs. 20.45±2.12 cm, P<0.05), reduced IVMD (64.27±12.29 vs. 71.39±13.64 ms, P<0.05), decreased MRA (3.09±1.12 vs. 3.73±1.19 cm2, P<0.05), and reduced average annual treatment cost (1.30±0.1 vs. 2.20±0.2 million Yuan, P<0.05). The RS/R-SD5 in the left univentricular pacing by RAAVD group was negatively correlated with improvements in cardiac function (r=−0.394, P=0.031). Conclusions Left univentricular pacing by RAAVD has treatment effects similar to those of standard biventricular pacing, and is an economically and physiologically effective method for biventricular systolic resynchronization in the treatment of CHF.
登录
查看更多内容
影响因子：
6.1
作者：
Khaykin, Yaariv;Exner, Derek;Sambelashvili, Aleksandre
通讯作者：
Sambelashvili, Aleksandre
影响因子：
13
作者：
Starling, Randall C.;Krum, Henry;Martin, David O.
通讯作者：
Martin, David O.
影响因子：
6.1
作者：
Wang Ru-xing;Guo Tao
通讯作者：
Guo Tao
DOI：
10.1093/europace/euv381
发表时间：
2016-12
期刊：
Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology
影响因子：
--
作者：
Remme EW;Niederer S;Gjesdal O;Russell K;Hyde ER;Smith N;Smiseth OA
通讯作者：
Smiseth OA
影响因子：
39.3
作者：
Cleland JG;Abraham WT;Linde C;Gold MR;Young JB;Claude Daubert J;Sherfesee L;Wells GA;Tang AS
通讯作者：
Tang AS