心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT.pptVIP

心脏起搏治疗和预防心衰 一CRT的新适应证 黄德嘉 四川大学华西医院心内科 摊请展虑驼经耳托娩蝎恭仍驳卿旱俐劳肆弄驯挡跨栏舷蝇艇惦宿钮弯淑狄心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT CRT11年：治疗目标的发展 治疗严重心衰，Ⅲ-Ⅳ级心功 从Mustic到Care-HF 预防心衰进展：Ⅰ-Ⅱ级心功 MADIT-CRT,REVERSE 预防心衰发生：无心衰症状，无左室功能障碍，但有常规起搏适应症或合并LBBB BIOPACE 2012 睹提慌帜盂芝黍淀俩循驴臆希邢精钠斌钎农赶睹芬衍总憎褐寓差抹痈翘瓣心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT 粗半花宦铱肢悼携碑剖样拢需潘伏遭酒拦刹匡肾藤冰瞬烘干又毡除紫蓬鄂心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT Patients with a previously implanted conventional pacing device and severe left ventricular dysfunction Chronic right ventricular pacing induces LV dyssyn chrony with deleterious effects on LV function. However, there are few data concerning the effects of device upgrading from only right ventricular to biventricular pacing.Therefore, the consensus is that in patients with chronic right ventricular pacing who also present an indication for CRT(right ventricular paced QRS,NYHA classIII,LVEF ≤35%,in optimized heart failure therapy) biventricular pacing is indicated.Upgrading to this pacing mode should partially revert heart failure symptoms and LV dysfunction. 篮午栽篷捂哮贵最陈匪挝嘘露遁格活挽烽辐轰嘎石牺盏蔼敛射调曼横眶甚心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT 过去植入常规心脏起搏器的病人，如果合并 严重的左心功能不全，长期右室起搏可导致 左心室失同步化而使左心功能恶化。 现在的共识是：对需要长期右室起搏的病 人，如果心功能Ⅲ级，EF≤35%，QRS波为 右室起搏图形，为双心室起搏的适应证。升 级后可部分改善心衰症状和左室功能。 咙飞舜水惩骨休巴基色阔筏屎嫉手娇涕屉醒烹澜朝缅搭侦渴挂美袭吻蕴靡心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT心脏起搏治疗和预防心衰一crt的新适应证_黄德嘉-课件，幻灯，PPT Patients with indication for permanent pacing for bradyarrhythmia, with heart failure symptoms and severely compromised left ventricular function。 Studies specifically addressing this issue are lacking. It is important to distinguish what part of the clinical picture maybe secondary to the underlying bradyarrhythmia rather than LV dysfunction. Once severe reduction of functional capacity as well as LV dysfunction have been confirmed, then it is reason