Results of atrioventricular synchronous pacing with optimized delay in patients with severe congestive heart failure.
Results of atrioventricular synchronous pacing with optimized delay in patients with severe congestive heart failure.
复制标题
严重充血性心力衰竭患者优化延迟房室同步起搏的结果。
DOI：
10.1016/s0002-9149(99)80687-0
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发表时间：
1995
期刊：
影响因子：
--
通讯作者：
Lars Ryde´n
中科院分区：
文献类型：
--
作者：
C. Linde;F. Gadler;M. Edner;R. Nordlander;M. Rosenqvist;Lars Ryde´n
为了验证房室同步起搏(房室同步起搏)是否能改善严重充血性心力衰竭患者的病情，我们对10例严重心力衰竭患者植入了房室同步起搏器(纽约心脏协会[NYHA]分级III~IV级)。起搏器植入一天后，通过多普勒超声心动图测量主动脉流出道来优化房室延迟。在植入起搏器后1、3和6个月对患者进行NYHA分级、每搏量、心输出量、射血分数和生活质量评估。虽然优化的房室延迟与每搏输出量和心输出量的短期改善有关(基线每搏量=22±7ml，第1天=28±12毫升；p=0.03：基线心输出量=1.9±0.6 L/分钟，第1天=2.2±1.1 L/分钟；p=0.1)，但平均每搏量、心输出量、NYHA分级和射血分数在起搏1、3和6个月后与基线值相比没有显著变化。3例患者在随访期间NYHA分级有改善。仅有1例患者在每搏量、心输出量、NYHA分级和射血分数方面持续改善。综上所述，我们没有发现房室同步起搏与优化的房室延迟对严重心力衰竭患者的有益影响。
To verify that atrioventricular (AV) synchronous pacing (DDD) with short AV delay improves the condition of patients with severe congestive heart failure, we implanted DDD pacemakers in 10 patients with severe heart failure (New York Heart Association [NYHA] class III to IV). One day after pacemaker implantation, the AV delay was optimized by Doppler echocardiographic measurements over the aortic outflow tract. Patients were evaluated regarding NYHA class, stroke volume, cardiac output, ejection fraction, and quality of life at 1, 3, and 6 months after pacemaker implantation. Although the optimized AV delay was associated with short-term improvement in stroke volume and cardiac output (baseline stroke volume = 22 ± 7 ml, day 1 = 28 ± 12 ml; p = 0.03: baseline cardiac output = 1.9 ± 0.6 L/min, day 1 = 2.2 ± 1.1 L/min; p = 0.10), the mean stroke volume, cardiac output, NYHA class, and ejection fraction did not change significantly after 1, 3, and 6 months of pacing compared with baseline values. Three patients improved in NYHA class during the follow-up. A consistent improvement in stroke volume, cardiac output, NYHA class, and ejection fraction was observed in only 1 patient. In conclusion, we found no beneficial effects of AV-synchronous pacing with optimized AV delay in patients with severe heart failure.