BƯỚC đầu áp DỤNG PHƯƠNG PHÁP tái ĐỒNG bộ (CRT) TRONG điều TRỊ BỆNH NHÂN SUY TIM tại BỆNH VIỆN đại học y được HUẾ

371
U ÁP DNG B U TR
BNH NHÂN SUY TIM TI BNH VII HC HU

Hun, Hoàng Anh Tin
1

2


3

1
Bnh vii hc Y c Hu
2
i hc Oregon, Hoa K
3
i hc California, Hoa K


: 
y






---Jude, Medtronic,

 

 

-
-V: 26,33± 6,31 ms

 



SUMMARY
PRELIMINARY APPLICATION OF THE CARDIAC RESYNCHRONIZATION
THERAPY IN HEART FAILURE PATIENTS AT HUE UNIVERSITY HOSPITAL
Aim: The ventricular conduction disturbance in the heart failure patients make outcome
more seriously because of the dysynchronisation so we try on to apply the cardiac
resynchronization therapy to reestablish its condition.
Patients and methods: From February 2009 to February 2011 fifteen patients having the
III
rd
and IVth degree of heart failure NYHA classification were recruited to be implanted the
CRT device at Hue University Hospital. The selected criteria will be EF indice < 30%, LVEDd >
60 mm, QRS duration > 120ms, PR interval > 160 ms. All patients were underwent the OMT for
at least one year but without the suitable result. The CRT devices were from Saint Jude,
Medtronik , Biotronik .
Results: There were 14/15 cases which were well responded with CRT implantation.
Concretely, the increasing of EF indice , the diminution of LVD and PAPS significantly after
one year. Particularly, the functional symptoms recovered by based upon the heart failure NYHA
degree . For the progamation, the important A-V duration was be optimsed with 152 ± 8,33ms as
well as the duration V-V 26,33± 6,31 ms which were the suitable parameters for follow up.
Conclusion: With the preliminary results, we can considered the application of the CRT in
severe heart failure patients as the encouraging therapy and the more study with more patients

will be needed ./.

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

 





 










 

- 
- 
- 
- 


- - 
- -) -P (má
-Jude, Medtronic, Biotronik.
- 
- 
máy.






ECG.





-  - 5 ngày. 

- 



373










374




12/3

V
Gan to

7/8
4/15


TST
PR
QRS

14/15
96 ± 8,5 ck/phút
292 ± 128 ms
169 ± 28 ms




90 ± 9,6 mmHg
60 ± 7,4 mmHg
Siêu âm tim
EF
Dd
PAPS


20,67 ± 9,23%
70,11 ± 22 mm
48 ± 11 mmHg
15/15

Digital


Nitrat
Dobutamin

10/15
11/15
9/15
8/15
5/15

CRT-
CRT-

10/15

5/15

 




2
Thành công
14

1




P
TST
95± 21
84± 17
<0,05
HATT
90±9,6
100± 7,8
<0,05
HATTr
60±7,4
62± 4,7
NS


I
II
III
IV




7
8
4/15


12
3

1/15



máy
Sau 1
tháng
2 tháng
3 tháng
6 tháng
9 tháng

EF(%)

Dd(mm)
PAPS
(cm
2
)
20,67±4,9
70,11±7,1
48±5,1
7,9±4,1
27,99±5,7
58±6,9
47,6±7,3
5,7±1,3
32,22±6,8
54±5,4
45±6,9
5,3±1,0
37,44±5,9
51±5,4
42±8,1
4,9±0,7
40,7±5,6
50±6,7
37±9,3
4,5±0,4
40,5±6,1
48±6,8
33±8,21
4,3±0,6
39,6±4,8

50±5,4
31±9,05
4,2±0,8
375



Sau 1 tháng
3 tháng

A-V delay (ms)
V-V delay (ms)

155± 9,7
39,11± 5,21
142± 10,4
34,12± 8,22
152± 8,33
26,33± 6,31









2.5± 0,3
3.5± 0.4

2.0± 0,21
3.4± 0.3
2.0±0,17
3.2± 0,26
QRS (ms)
135± 4,2
127± 9,4
116± 2,9
121± 1,2







- 
RS >120ms. EF = 35%. Dd = 60-70mm, EF = 25 

- 

  -      

- 




-  





   



-
376
-




(CRT-


- 

- (152 ±
-
 250ms, và V--40
], [9].


- 
- 




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
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