论文部分内容阅读
目的:探讨心电图QRS时限和形态对心脏再同步治疗(CRT)效果的影响。方法:入选植入CRT/D装置的患者272例,依据术前心电图QRS时限将其分为轻度延长(120~149ms)组、中度延长(150~179ms)组和重度延长(≥180ms)组,比较3组患者CRT反应情况;依据左束支阻滞(LBBB)诊断新标准,将患者分为真性LBBB组和假性LBBB组,比较两组患者CRT反应情况。结果:QRS时限中度(62.8%)、重度(54.3%)延长组CRT反应率优于轻度(49.6%)延长组;真性LBBB组CRT反应率优于假性LBBB组(64.3%︰52.9%)。多因素分析显示宽QRS波和真性LBBB与CRT反应率增加有关。结论:QRS时限中、重度延长组患者CRT反应率优于轻度延长组,而中度和重度延长组患者间CRT反应率无明显差别;真性LBBB组CRT反应率优于假性LBBB组。
Objective: To investigate the effect of ECG QRS duration and morphology on cardiac resynchronization therapy (CRT). Methods: A total of 272 patients were enrolled in the CRT / D device. They were divided into mild prolongation (120 ~ 149ms), moderate prolongation (150 ~ 179ms) and severe prolongation (≥180ms) The CRT response was compared between the three groups. According to the new diagnostic criteria of left bundle branch block (LBBB), the patients were divided into the real LBBB group and the pseudo LBBB group, and the CRT response was compared between the two groups. Results: The response rate of CRT with prolonged QRS (62.8%) and severe (54.3%) was better than mild (49.6%). The response rate of true LBBB was higher than that of pseudo LBBB (64.3%: 52.9% ). Multivariate analysis showed that wide QRS complex and true LBBB were associated with an increased response rate to CRT. Conclusions: The response rate of CRT in patients with moderate and severe prolongation of QRS duration is better than that of mild LBBB in patients with moderate to severe prolongation of QRS. The response rate of CRT in true LBBB is superior to false LBBB.