CRT后心衰改善对室性心律失常减少的预测价值

杨阳; 严激

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CRT后心衰改善对室性心律失常减少的预测价值

临床研究 | 更新时间：2025-10-15

- CRT后心衰改善对室性心律失常减少的预测价值
- Predictive value of changes in left ventricular ejection fraction for ventricular arrhythmias after cardiac resynchronization therapy
- 临床心电学杂志 2019年28卷第2期页码：101-105
- 作者机构：
  
  安徽医科大学附属省立医院
- 作者简介：
- 基金信息：
  
  中央引导地方科技发展专项项目（2016080802D113）;安徽省卫生和计划生育委员会科研计划项目（2016QK002）
- DOI：
  中图分类号： R541.7
- 纸质出版：2019
- 稿件说明：
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[1]杨阳,严激.CRT后心衰改善对室性心律失常减少的预测价值[J].临床心电学杂志,2019,28(02):101-105.

Yang yang, Yan ji. Predictive value of changes in left ventricular ejection fraction for ventricular arrhythmias after cardiac resynchronization therapy[J]. 2019, 28(2): 101-105.
[1]杨阳,严激.CRT后心衰改善对室性心律失常减少的预测价值[J].临床心电学杂志,2019,28(02):101-105. DOI：

Yang yang, Yan ji. Predictive value of changes in left ventricular ejection fraction for ventricular arrhythmias after cardiac resynchronization therapy[J]. 2019, 28(2): 101-105. DOI：

摘要

目的通过观察心脏再同步化治疗除颤器（CRT-D）术前及术后第12月左室射血分数（LVEF）的变化与术后室性心律失常（VA）的发生情况

探讨术后LVEF的变化情况与VA风险的关系。方法回顾性分析安徽省立医院2014年1月至2016年8月CRT-D患者

以是否发生室性心律失常分为病例组及对照组

比较两组基线资料及术后第12月LVEF变化与VA发生情况的关系。结果研究共纳入对象210例

平均随访18.0±4.7个月

病例组共43（20.5%）名患者记录到不同类型VA事件。多因素logistic回归分析提示缺血性心肌、ICD一级预防、△LVEF是CRT患者术后VA发生风险的独立预测因素。进一步分析提示CRT术后LVEF提升低于11%的发生VA风险大。结论心脏再同步化治疗后患者LVEF提升

VA风险下降

与LVEF提升的程度有关

提升的程度越大

VA风险越低。

Abstract

Objective To explore the correlation between the changes of left ventricular ejection fraction(LVEF) before and 12 months after cardiac resynchronization therapy defibrillator(CRT-D) and the occurrence of postoperative ventricular arrhythmias(VA). Methods A retrospective analysis of patients with CRT-D from January 2014 to August 2016 in Anhui Provincial Hospital was divided into case group and control group according to whether ventricular arrhythmia occurred. The baseline data of the two groups and the change of LVEF in the 12 th month after operation were compared. The relationship between the occurrence of VA. Results A total of 210 patients were enrolled in the study. The mean follow-up was 18.0 ± 4.7 months. A total of 43(20.5%) patients in the case group recorded different types of VA events. Multivariate logistic regression analysis indicated that ischemic myocardium

primary prevention of ICD

and △LVEF were independent predictors of postoperative VA risk in patients with CRT. Further analysis suggested that the risk of VA was higher when the LVEF increased by less than 11% after CRT. Conclusions After cardiac resynchronization therapy

patients with LVEF increased had a decreasing of VA risks

the VA risks was related to the degree of LVEF elevation post-CRT. The higher the degree of LVEF elevation

the lower the VA risks.

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references

Change in Left Ventricular Ejection Fraction Following First Myocardial Infarction and Outcome [J] . Derek S. Chew,Huikuri Heikki,Georg Schmidt,Katherine M. Kavanagh,Michael Dommasch,Poul Erik Bloch Thomsen,Daniel Sinnecker,Pekka Raatikainen,Derek V. Exner. JACC: Clinical Electrophysiology . 2018 (5)

Meta-analysis of Risk of Ventricular Arrhythmias After Improvement in Left Ventricular Ejection Fraction During Follow-Up in Patients With Primary Prevention Implantable Cardioverter Defibrillators [J] . Aiman Smer,Alok Saurav,Muhammad Soubhi Azzouz,Mohsin Salih,Mohamed Ayan,Ahmed Abuzaid,Abhilash Akinapelli,Arun Kanmanthareddy,Lynda E. Rosenfeld,Faisal M. Merchant,Hussam Abuissa. The American Journal of Cardiology . 2017 (2)

Reduced risk of life‐threatening ventricular tachyarrhythmias with cardiac resynchronization therapy: relationship to left ventricular ejection fraction [J] . Valentina Kutyifa,Arthur J. Moss,Scott D. Solomon,Scott McNitt,Mehmet K. Aktas,Alon Barsheshet,Bela Merkely,Wojciech Zareba,Ilan Goldenberg. Eur J Heart Fail . 2015 (9)

Left Ventricular Ejection Fraction Normalization in Cardiac Resynchronization Therapy and Risk of Ventricular Arrhythmias and Clinical Outcomes: Results From the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy （MADIT–CRT） Trial [J] . Martin H. Ruwald,Scott D. Solomon,Elyse Foster,Valentina Kutyifa,Anne-Christine Ruwald,Saadia Sherazi,Scott McNitt,Christian Jons,Arthur J. Moss,Wojciech Zareba. Circulation . 2014 (25)

Normalization of Left Ventricular Ejection Fraction after Cardiac Resynchronization Therapy Also Normalizes Survival [J] . MAHESH MANNE,JOHN RICKARD,NIRAJ VARMA,MINA K. CHUNG,PATRICK TCHOU. Pacing and Clinical Electrophysiology . 2013 (8)

Reverse Remodeling and the Risk of Ventricular Tachyarrhythmias in the MADIT-CRT （Multicenter Automatic Defibrillator Implantation Trial–Cardiac Resynchronization Therapy） [J] . Alon Barsheshet,Paul J. Wang,Arthur J. Moss,Scott D. Solomon,Amin Al-Ahmad,Scott McNitt,Elyse Foster,David T. Huang,Helmut U. Klein,Wojciech Zareba,Michael Eldar,Ilan Goldenberg. Journal of the American College of Cardiology . 2011 (24)

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