Does Atrial Resynchronization Confer Further Benefit on Patients Undergoing Ventricular Resynchronization Therapy?

摘要

Congestive heart failure is considered to be one of the most important public health problems in cardiovascular medicine. In the United States, more than 3 million people are afflicted by the disease, with nearly 400 000 new cases diagnosed annually. Congestive heart failure is associated with increasing morbidity and high mortality and has overall 5-year survival rates of 25% and 38% for men and women respectively, with a median survival time of 1.7 years for men and 3.2 years for women. The therapeutic approach has evolved over the years as understanding of the disease and its associated compensatory mechanisms increased, and recently pacing therapy has been introduced into clinical practice. Patients with heart failure frequently have altered electrical activation which may lead to asynchronous contraction of the heart and to further impairment of their hemodynamic status. These data suggested the hypothesis that resynchronization of the electrical activity of the heart may improve the mechanics of the heart and, consequently, the performance of the whole cardiovascular system.