慢性心力衰竭器械治疗新技术
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New technology of device therapy for chronic heart failure
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    摘要:

    慢性心衰的器械治疗新技术主要集中在改善电-机械传导和改善心脏机械结构两方面。改善电-机械传导方面,心脏再同步化治疗(cardiac resynchronization therapy,CRT)已成为合并心室内传导阻滞的中-重度慢性心力衰竭患者的标准疗法。但是近30%的CRT无反应是临床希望改善疗效的努力方向,新技术主要在于增加反应率,包括多位点起搏-左室心内膜起搏-无导线左室心内膜起搏,以及心衰肺阻抗监测。另外,心肌收缩力调节器(cardiac contractility modulation, CCM)自2001年植入以来也得到越来越多的临床应用。改善心脏机械结构领域,瓣膜修复和左室辅助装置的进展近年被较多提及。慢性心衰器械治疗的新技术近几年发展迅速,特别是新工具的应用,使得手术更加便捷-手术更加微创。相信随着越来越多临床试验的进展,新技术的应用将越来越广泛,心衰治疗的疗效将得到进一步改善。

    Abstract:

    The new technology of device therapy for chronic heart failure is mainly focused on two aspects, improving the electrical mechanical conduction and improving the mechanical structure of the heart. For improvement of electro-mechanical conduction, cardiac resynchronization therapy (CRT) has become the standard therapy for patients with moderate or severe chronic heart failure and ventricular conduction block. However nearly 30% of the CRT non-respond rate makes it the clinical hope to improve the curative effect. New technology mainly lies in increasing the respond rate, including multisite pacing, left ventricular endocardia pacing, wireless left ventricular endocardia pacing, and pulmonary impedance monitoring. In addition, contractility modulation cardiac (CCM) has more and more clinical application since it was first implanted in 2001. To improve the cardiac mechanical structure, the progress of valve repair and left ventricular assist device has been widely mentioned in recent years. New technology in the treatment of chronic heart failure has developed rapidly in recent years. Especially the application of new tools has made the operation more convenient and minimally invasive. With the progress of more and more clinical trials, it is believed that the application of new technologies will be more and more extensive, and the efficacy of heart failure treatment will be further improved.

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沈法荣.慢性心力衰竭器械治疗新技术[J].南京医科大学学报(自然科学版),2016,(4):390-394

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  • 收稿日期:2016-02-19
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  • 在线发布日期: 2016-05-11
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