The Use Of Cardiac Resynchronization Therapy In Chronic Heart Failure

Objective:To investigate the curative effect of cardiac resynchronization therapy(CRT) on chronic heart failure.Method:We selected one patient with complete left bundle branch block,Ⅰ°atrioventricular block and heart failure(NYHA ClassⅢ) as a objective.Then we arranged a cardiac resynchronization therapy pacemaker for him on 2006.12.2.The process was smooth.We observed his changes of symptoms,heart function and outcomes of six minute corridor walk test (6MWT).At the same time,we detected and optimized the pacemaker parameters after the surgery.Through these changes,we evaluated the curative effect of cardiac resynchronization therapy and investigated the optimization.Results:The QRS duration was 158ms before the surgery and 120ms after the surgery.The LVEDD was 72mm and 61mm respectively.Six Minute Corridor Walk Test(6MWT) was 316m and 449m before and 3 months after the surgery.At the same time the symptoms and life quality were improved.We optimized the pacemaker parameters 1 month after the surgery under sinus heart rhythm through measuring left ventricular ejection fraction(LVEF),stroke volume(SV), Cardiac Output(CO),left ventricular filling time(LVFT) and mitral regurgitation in echocardiography.We select 110ms and 12ms as AV and VV duration.There was frequent ventricular tachycardia and paroxysmal ventricular tachycardia in Holter before surgery.After surgery there was occasional ventricular tachycardia in Holter.Later we found paroxysmal ventricular tachycardia occurred 4 beats and 5 beats on 2007.1.10 and 2007.4.12 respectively.Conclusions:As an important therapy for chronic heart failure with cardiac resynchronization, CRT can improve heart function,symptoms and life quality and reverse left ventricular remodeling.CRT has more recordable and diagnostic functions compared to normal pacemaker.