邹彤,佟佳宾,施海峰,陈浩,刘俊鹏,张倩,王志蕾,金鑫,吴素娟,曲祎玫,杨杰孚

• 1:北京医院心内科
• 2:中国医科大学

摘要(Abstract)：

目的初步探讨左心室四极导线在心脏再同步化治疗(cardiac resynchronization therapy,CRT)中的临床应用。方法选取北京医院心内科2014年1月至2015年9月连续收治的CRT新植入患者共40例,分为四极导线组(13例)和双极导线组(27例)。比较两组患者的手术时间、X线曝光时间、心功能改善及并发症发生情况等的差异。结果两组患者左心室导线置入时间、手术时间、X线曝光时间、左心室导线位置比较,差异均无统计学意义(均P>0.05)。术后6个月,四极导线组左心室射血分数(LVEF)[(38.2±4.1)%比(33.3±5.0)%,P=0.026]、纽约心脏病协会(NYHA)心功能分级[(2.4±0.4)级比(2.8±0.6)级,P=0.037]、CRT有反应率[11例(84.6%)比18例(66.7%),P=0.017]和心功能改善≥1级[10例(76.9%)比18例(66.7%),P=0.019]均优于双极导线组。此外,对于QRS波时限的缩短[(141.7±14.0)ms比(154.4±15.3)ms,P=0.006],四极导线组优势更为显著;而对于左心室舒张末期内径改善的比较,两组间差异无统计学意义(P>0.05)。四极导线组在围术期对于膈神经刺激和阈值的管理优于双极导线组。结论短期随访提示左心室四极导线在血流动力学改善、CRT有反应率和临床疗效方面均优于双极导线。

关键词(KeyWords)： 心脏再同步化治疗;左心室四极导线;膈神经刺激;NYHA心功能分级

Abstract:

Keywords:

基金项目(Foundation): 国家自然科学基金项目(81170171)

作者(Author): 邹彤,佟佳宾,施海峰,陈浩,刘俊鹏,张倩,王志蕾,金鑫,吴素娟,曲祎玫,杨杰孚

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