曹芳英,柳景华

• 1:首都医科大学附属北京安贞医院心内科北京市心肺血管疾病研究所

摘要(Abstract)：

<正>心力衰竭是各种心脏疾病的严重和终末期阶段,发病率及病死率高,其主要死因为左心功能衰竭~[1]。大约1/3心力衰竭晚期患者存在心电传导异常及机械收缩不同步,而心脏整体收缩不协调导致血流动力学紊乱,促进左心室重构,使心力衰竭加重,形成恶性循环。心脏再同步化治疗(cardiac resynchronization therapy,CRT)通过恢复双心室电活动同步性,提高左心室收缩功能,从而改善心力衰竭症状,逆转左心

关键词(KeyWords)： 心脏再同步化治疗;左心室起搏;心力衰竭;多位点起搏

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金面上项目(8157020075)

作者(Author): 曹芳英,柳景华

参考文献(References)：

• [1]中华医学会心血管病学分会,中华心血管病杂志编辑委员会.中国心力衰竭诊断和治疗指南2014.中华心血管病杂志,2014,42(2):98-122.
• [2]Birnie DH,Tang AS.The problem of non-response to cardiac resynchronization therapy.Curr Opin Cardiol,2006,21(1):20-26.
• [3]Zanon F,Baracca E,Pastore G,et al.Multipoint pacing by a left ventricular quadripolar lead improves the acute hemodynamic response to CRT compared with conventional biventricular pacing at any site.Heart Rhythm,2015,12(5):975-981.
• [4]Pappone C,'Calovi'cZ,Vicedomini G,et al.Improving cardiac resynchronization therapy response with multipoint left ventricular pacing:Twelve-month follow-up study.Heart Rhythm,2015,12(6):1250-1258.
• [5]Calo L,Martino A,de Ruvo E,et al.Acute echocardiographic optimization of multiple stimulation configurations of cardiac resynchronization therapy through quadripolar left ventricular pacing:a tailored approach.Am Heart J,2014,167(4):546-554.
• [6]Daubert JC,Saxon L,Adamson PB,et al.2012 EHRA/HRS expert consensus statement on cardiac resynchronization therapy in heart failure:implant and follow-up recommendations and management.Heart Rhythm,2012,6(9):1524-1576.
• [7]Gamble JH,Betts TR.Multisite left ventricular pacing in cardiac resynchronization therapy.Future Cardiol,2014,10(4):469-477.
• [8]Varma N.Variegated left ventricular electrical activation in response to a novel quadripolar electrode:visualization by noninvasive electrocardiographic imaging.J Electrocardiol,2014,47(1):66-74.
• [9]Ploux S,Strik M,van Hunnik A,et al.Acute electrical and hemodynamic effects of multisite left ventricular pacing for cardiac resynchronization therapy in the dyssynchronous canine heart.Heart Rhythm,2014,11(1):119-125.
• [10]Forleo GB,Di Biase L,Panattoni G,et al.Improved implant and postoperative lead performance in CRT-D patients implanted with a quadripolar left ventricular lead.A 6-month follow-up analysis from a multicenter prospective comparative study.J Interv Card Electrophysiol,2015,42(1):59-66.
• [11]Yamasaki H,Seo Y,Tada H,et al.Clinical and procedural characteristics of acute hemodynamic responders undergoing triple-site ventricular pacing for advanced heart failure.Am J Cardiol,2011,108(9):1297-1304.
• [12]Crossley GH,Biffi M,Johnson B,et al.Performance of a novel left ventricular lead with short bipolar spacing for cardiac resynchronization therapy:primary results of the Attain Performa quadripolar left ventricular lead study.Heart Rhythm,2015,12(4):751-758.
• [13]Yoshida K,Seo Y,Yamasaki H,et al.Effect of triangle ventricular pacing on haemodynamics and dyssynchrony in patients with advanced heart failure:a comparison study with conventional bi-ventricular pacing therapy.Eur Heart J,2007,28(21):2610-2619.
• [14]Ginks MR,Duckett SG,Kapetanakis S,et al.Multi-site left ventricular pacing as a potential treatment for patients with postero-lateral scar:insights from cardiac magnetic resonance imaging and invasive haemodynamic assessment.Europace,2012,14(3):373-379.
• [15]Padeletti L,Colella A,Michelucci A,et al.Dual-site left ventricular cardiac resynchronization therapy.Am J Cardiol,2008,102(12):1687-1692.
• [16]Leclercq C,Gadler F,Kranig W,et al.A randomized comparison of triple-site versus dual-site ventricular stimulation in patients with congestive heart failure.J Am Coll Cardiol,2008,51(15):1455-1462.
• [17]Rogers DP,Lambiase PD,Lowe MD,et al.A randomized doubleblind crossover trial of triventricular versus biventricular pacing in heart failure.Eur J Heart Fail,2012,14(5):495-505.
• [18]Ogano M,Iwasaki YK,Tanabe J,et al.Antiarrhythmic effect of cardiac resynchronization therapy with triple-site biventricular stimulation.Europace,2013,15(10):1491-1498.
• [19]Lenarczyk R,Kowalski O,Kukulski T,et al.Mid-term outcomes of triple-site vs.conventional cardiac resynchronization therapy:a preliminary study.Int J Cardiol,2009,133(1):87-94.
• [20]Behar JM,Bostock J,Ginks M,et al.Limitations of chronic delivery of multi-vein left ventricular stimulation for cardiac resynchronization therapy.J Interv Card Electrophysiol,2015,42(2):135-142.
• [21]Rinaldi CA,Kranig W,Leclercq C,et al.Acute effects of multisite left ventricular pacing on mechanical dyssynchrony in patients receivingcardiac resynchronization therapy.J Card Fail,2013,19(11):731-738.
• [22]Rinaldi CA,Leclercq C,Kranig W,et al.Improvement in acute contractility and hemodynamics with multipoint pacing via a left ventricular quadripolar pacing lead.J Interv Card Electrophysiol,2014,40(1):75-80.
• [23]Pappone C,Calovic Z,Vicedomini G,et al.Multipoint left ventricular pacing improves acute hemodynamic response assessed with pressure-volume loops in cardiac resynchronization therapy patients.Heart Rhythm,2014,11(3):394-401.
• [24]Pappone C,'C alovi'cZ,Vicedomini G,et al.Multipoint left ventricular pacing in a single coronary sinus branch improves midterm echocardiographic and clinical response to cardiac resynchronization therapy.J Cardiovasc Electrophysiol,2015,26(1):58-63.
• [25]Alonso P,Andrés A,Osca J,et al.Improvement in hemodynamics and contractility with multipoint left ventricular pacing in cardiac resynchronization therapy.Rev Esp Cardiol(Engl Ed),2014,67(10):859-861.
• [26]Sohal M,Shetty A,Niederer S,et al.Mechanistic insights into the benefits of multisite pacing in cardiac resynchronization therapy:The importance of electrical substrate and rate of left ventricular activation.Heart Rhythm,2015,12(12):2449-2457.