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心脏再同步化治疗(CRT)是心力衰竭终末期治疗的重要手段,但20%～30%的病人CRT后无应答。合理地定义CRT的应答,更注重患者症状改善和获益,关注新的预测有应答的方法 ,严格地掌握CRT的适应证,合理拓展CRT的适应证,合理选择心室电极植入位置,术后做好优化AV/VV间期等管理措施,都将有效地提高CRT的应答率。而对于CRT能否增加室性心律失常的发生等问题,仍需要进一步的研究。
Cardiac resynchronization therapy (CRT) is an important treatment for end-stage heart failure, but 20% to 30% of patients have no response after CRT. Reasonably define the CRT response, pay more attention to the patient’s symptoms and benefit, pay attention to the new prediction and response method, strictly control the indications of CRT, reasonably expand the indications of CRT, reasonably select the location of ventricular electrode implantation, postoperative Optimizing AV / VV interval and other management measures, will effectively improve the response rate of CRT. However, CRT can increase the incidence of ventricular arrhythmias and other issues, still need further study.