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【medical-news】Dual-chamber起搏器帮助心力衰竭
A heart attack, high blood pressure, and other insults can reshape the heart in ways that derail the "beat now" signals that are vital to a healthy heartbeat. The two lower chambers, the right ventricle and left ventricle, should contract and relax together. In many people with heart failure, though, they don't. This loss of synchronized squeezing costs the heart some of its pumping power.
A biventricular pacemaker can fix this problem. It sends carefully timed signals that make the right and left ventricle contract and relax in unison. This is called cardiac resynchronization therapy. Biventricular pacemakers were initially approved for people with severe heart failure. Greater experience with them will almost certainly broaden the population of folks who could benefit from one.
Results of an international trial suggest that combining a biventricular pacemaker with an implantable cardioverter-defibrillator (ICD) — a device that can shock the heart out of a potentially lethal rhythm — helps prevent deaths from sudden cardiac arrest and hospitalizations for heart failure better than an ICD alone (New England Journal of Medicine, Dec. 16, 2010). The downside of this double therapy is an increase in hospitalizations due to problems with the devices.
This dual therapy isn't for everyone with heart failure. Instead, it could be a good option for those with moderate to severe heart failure who have a low ejection fraction (a sign of imperiled pumping in the left ventricle) along with changes on an electrocardiogram that suggest the ventricles aren't beating together (a wide QRS interval). And it definitely isn't a replacement for medications, watching what you eat and drink, and balancing rest and exercise. But in combination with those strategies, a biventricular pacemaker and an ICD can help you feel better by keeping your heart in sync and help you live longer by halting potentially deadly rhythms. 双腔起搏器，治疗心力衰竭
A heart attack, high blood pressure, and other insults can reshape the heart in ways that derail the "beat now" signals that are vital to a healthy heartbeat. The two lower chambers, the right ventricle and left ventricle, should contract and relax together. In many people with heart failure, though, they don't. This loss of synchronized squeezing costs the heart some of its pumping power.
心脏骤停、高血压等一些疾病，能够使心脏打破原有的结构，而进行心脏重构。但原有的正常的结构，对维持心脏正常的跳动来说，是非常重要的。位于心脏较低位置的两个心腔，即左右心室，本应该是一起收缩、一起舒张的；但对于许多患有心衰的患者来说，已经不能同步进行了。同步舒缩的缺失，增加了心脏的泵血负荷。
A biventricular pacemaker can fix this problem. It sends carefully timed signals that make the right and left ventricle contract and relax in unison. This is called cardiac resynchronization therapy. Biventricular pacemakers were initially approved for people with severe heart failure. Greater experience with them will almost certainly broaden the population of folks who could benefit from one.
一个两心室的起搏器可以解决这个问题。双腔起搏器能够定时发送信号，来使左右心室一同收缩、舒张。这就是所谓的心脏再同步化治疗。双腔起搏器最初被批准应用于严重心力衰竭的患者。随着应用经验的丰富，其应用范围也在扩大，尽量将其应用在每一个能够从此获益的患者。
Results of an international trial suggest that combining a biventricular pacemaker with an implantable cardioverter-defibrillator (ICD) — a device that can shock the heart out of a potentially lethal rhythm — helps prevent deaths from sudden cardiac arrest and hospitalizations for heart failure better than an ICD alone (New England Journal of Medicine, Dec. 16, 2010). The downside of this double therapy is an increase in hospitalizations due to problems with the devices.
植入式心脏除颤器，是一种能够将患者从致命性的心律失常中挽救回来的设备，其能够阻止突发性心脏骤停及住院治疗的心力衰竭。2010年12月16日《新英格兰医学杂志》上公布了一项国际化实验的研究结果，其研究表明：与单独植入心脏除颤器的患者相比，同时植入了双腔起搏器的患者能更好的生存。不过，任何治疗都存在着两面性，这个双重治疗的副作用就是因为设备本身的问题而增加了住院率。
This dual therapy isn't for everyone with heart failure. Instead, it could be a good option for those with moderate to severe heart failure who have a low ejection fraction (a sign of imperiled pumping in the left ventricle) along with changes on an electrocardiogram that suggest the ventricles aren't beating together (a wide QRS interval).
这个双重治疗，并不是每一位心力衰竭的患者都适用。相反，对于那些有中度到重度的心力衰竭的患者来说，可能是一个较好的选择。中度到重度心力衰竭的患者，其射血分数已经降低。射血分数，即LVEF（Left Ventricular Ejection Fractions），是指：每搏输出量占心室舒张末期容积量的百分比。射血分数与心肌的收缩能力有关，心肌收缩能力越强，则每搏输出量越多，射血分数也越大。对于中度到重度心力衰竭的患者来说，也会在心电图上反映出两心室的跳动情况，即在心电图上表现出一个宽的QRS区间。
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作者:admin@医学,生命科学 2011-02-24 00:50
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