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Cardiac Resynchronization Therapy for Drug-Refractory Heart Failure: -A Single-Center Experience

並列摘要


Background: Heart failure (HF) is associated with high mortality and morbidity rates even after pharmacological treatment. This retrospective study aimed at analyzing the clinical benefits and patient outcomes after cardiac resynchronization therapy (CRT). Methods: We enrolled 12 patients with New York Heart Association (NYHA) functional class Ⅲ or Ⅳ HF, a left ventricular ejection fraction (LVEF) of ≦35%, and an intrinsic QRS duration of ≧120 ms. These patients were refractory to pharmacological treatment and underwent CRT-device implantation. Results: After a mean follow-up of 6 months after device implantation, the mean values of NYHA functional class has decreased and the values of LV remodeling parameters, namely the LV end-diastolic diameter (LVEDD), LV end-systolic diameter (LVESD), and LVEF, had improved. The treatment resulted in a 58% reduction in the frequency of HF-related hospitalization, and cardiac-cause mortality was 8% for the entire study group; the corresponding values were 42.8% and 14.3% for patients with ischemic HF and 80% and 0% for those with non-ischemic HF. Both patients with ischemic and non-ischemic HF showed improvement in all the LV remodeling parameters. None of the patients developed any immediate complication of device implantation but 1 patient developed left subclavian vein thrombosis 2 months after device implantation and was treated successfully with anti-coagulant therapy. Conclusions: This small-scale, retrospective study of a drug refractory HF cohort revealed that CRT improves the quality of life, LVEF, LVEDD, and LVESD, and reduces cardiac-cause mortality and the frequency of HF related hospitalization both in ischemic and non-ischemic HF patients.

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