Efficacy And Security Of Cardiac Resynchhroni-zation Therapy For Patients With Chronic Heart Failure

Objective:To observed the efficacy and security of cardiac resynchronization therapy in patients with chronic heart failure.Methods:seventy-three patients with drug-refractory heart failure received CRT or CRTD implantation in this study during March2009to November2012. Observe the complications after the implantation and the follow up data of49patients, analysis the efficacy and security of cardiac resynchronization therapy.Results:Pacemaker were successfully implanted in all73patients.3patents died of multiple organ failure after the operation,1patient suffered hydropneumothorax after therapy and3patients were hospitalized for infection in the implant site in6months after therapy. Results from the remaining49patients showed that cardiac function significantly improved during follow up compared to the baseline. The left ventricular ejection fraction (LVEF) increased from (31.3±11.4)%to (37.4±14.8)%, P＜0.01; the left ventricular end diastolic dimension (LVDd) decreased from (5.72±2.53)cm to (5.53±2.39)cm, P＜0.01; the pulmonary arterial pressure decreased from (47.6±9.38)mmHg to (41.4±10.0)mmHg in the patients with pulmonary hyperten-sion, P＜0.01. There was no significant difference between female and male patients for the changes of LVEF and LVDd after therapy. Younger patients (age<65) showed a better improvement of LVEF than older patients (age≥65), P＜0.05. A significant difference was seen in the changes of LVEF and LVDd between mild and severe heart failure patients, the patients with New York Heart Association class III/IV heart failure seemed to have a better efficacy of cardiac resynchronization therapy.Conclusion:The operation of cardiac resynchronization therapy for heart failure patients is safe. The application of cardiac resynchronization therapy was associated with an improved cardiac function and a reversion of myocardial remodeling. The efficacy of female patients is equal or better than male patients. The cardiac functional grading and the age may affect the efficacy of CRT.