目的：探析在慢性心力衰竭治疗中采取心脏再同步治疗除颤器治疗的临床价值。方法32例药物治疗效果不理想的慢性心力衰竭患者,观察置入心脏再同步治疗除颤器的效果,并对患者临床症状进行随访。结果在实行心脏再同步治疗除颤器置入术中测量患者起搏参数：右心房起搏阈电压0.4~1.4 V,阻抗530~1500Ω；右心室起搏阈电压0.3~0.8 V,阻抗700~1200Ω；左心室起搏阈电压0.7~2.8 V,阻抗650~1300Ω,上述指标均较好,随访6~12个月后发现患者心功能显著改善。结论心脏再同步治疗除颤器应用在慢性心力衰竭中不但能够改善患者临床症状,提升左室射血分数水平,增加患者心功能,此外也能够起到预防心脏性猝死作用,对室性心动过速等恶性室性心律失常疾病的治疗有着重要意义,是目前临床研究中值得应用的治疗严重心力衰竭患者适应证的有效方式。%Objective To investigate clinical value by cardiac resynchronization therapy defibrillator in the treatment of chronic heart failure. Methods There were 32 chronic heart failure patients with unsatisfactory curative effect by drug therapy. Observation was made on effect by cardiac resynchronization therapy defibrillator in patients, along with follow-up on clinical symptom in patients. Results Measurement of pacing parameters during cardiac resynchronization therapy defibrillator operation showed right atrium pacing threshold voltage as 0.4~1.4 V and impedance as 530~1500 Ω, right ventricle pacing threshold voltage as 0.3~0.8 V and impedance as 700~1200 Ω, left ventricle pacing threshold voltage as 0.7~2.8 V and impedance as 650~1300 Ω. All indexes were good, and follow-up for 6~12 months showed obviously improved cardiac function in patients. Conclusion Application of cardiac resynchronization therapy defibrillator can not only improve clinical symptom, increase left ventricular ejection fraction and enhance cardiac function in patients with chronic heart failure, but also prevent sudden cardiac death. With its important significance in treating ventricular tachycardia as severe ventricular arrhythmias, this method acts as an effective method in clinical research for treating patients with severe chronic heart failure indications.
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