Improvement of Cardiac Function in Patients with Severe Congestive Heart Failure and Coronary Artery Disease by Dual Chamber Pacing with Shortened AV Delay
Improvement of Cardiac Function in Patients with Severe Congestive Heart Failure and Coronary Artery Disease by Dual Chamber Pacing with Shortened AV Delay
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双腔起搏缩短房室延迟改善严重充血性心力衰竭和冠状动脉疾病患者的心功能
DOI：
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发表时间：
1993
期刊：
影响因子：
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通讯作者：
Luigi Ghiariello
中科院分区：
文献类型：
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作者：
A. Auricchio;L. Sommariva;R. Salo;A. Scafuri;Luigi Ghiariello
药物治疗往往不能控制严重心力衰竭的症状。在两例冠状动脉疾病导致的严重心力衰竭患者中，通过植入具有短房室延迟（100 msec）的生理双室起搏器，在一定程度上改变整体心室功能的可能性。两例患者的基线临床症状均为腿部水肿、腹水、静息时呼吸困难，甚至是矫形呼吸，纽约心脏协会（NYHA）分级为III - IV级。在房室间期逐步缩短期间的急性血流动力学和超声心动图参数测量指导起搏器植入和房室延迟的设定。在心脏起搏器植入后的几天内，两名患者的临床状态和功能NYHA等级都得到了显著改善，其中一名患者改善到U级，另一名患者改善到II - III级。此外，收缩和舒张参数的改变与功能分类和临床状况的改善相一致。对于药物治疗难治性的严重心力衰竭患者，起搏器治疗对于那些药物治疗无效而生活质量严重受损的患者有相当大的益处。急性血流动力学和超声心动图检查有助于评估最合适的房室延迟和起搏模式。
Medical therapy often fails to control symptoms of severe heart failure. The possibility of modifying to some degree the global ventricular performance with the implantation of a physiological dual chamber pacemaker, set with a short atrioventricular delay (100 msec), has been adopted in two patients with severe heart failure due to coronary artery disease. The baseline clinical condition of both patients was characterized by leg edema, ascites, dyspnea at rest, or even orthopnea with a functional New York Heart Association (NYHA) class III‐IV. Acute measurements of hemodynamic and echocardiographic parameters during stepwise shortening of AV interval guided the pacemaker implantation and setting of AV delay in the chronic phase. Within a few days after pacemaker implantation, both patients considerably improved their clinical status as well as their functional NYHA class, improving to class U in one patient and to class II‐III in the other patient. In addition, modification of systolic and diastoJic parameters paralleled these improvements functional class and clinical condition. Pacemaker therapy in severe heart failure refractory to medical therapy can be of considerable benefit in patients whose quality‐of‐life is severely compromised when pharmacological therapy is no longer effective. Acute hemodynamic and echocardiographic testing is useful in assessing the most appropriate AV delay and pacing mode.
急性房室序贯起搏对左心室功能障碍患者的血流动力学影响。
DOI：
10.1016/0002-9149(82)91947-6
发表时间：
1982
期刊：
The American journal of cardiology
影响因子：
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作者：
Reiter,MJ;Hindman,MC
通讯作者：
Hindman,MC