来自南佛罗里达大学医学院坦帕分院的首席研究员Bengt Herweg博士告诉路透社的记者：“虽然心脏再同步治疗的双心室起搏器使得心力衰竭的治疗发生了质的变化，但是对于能否运用到依赖静脉用药的晚期患者身上仍有争议。”他和他的同事们研究了10名平均年龄为55岁的安装了心律转复除颤器的患者，他们的心衰程度都达到了纽约心脏协会分级的IV 级标准，正在接受多巴酚丁胺或是米力农维持其收缩功能。研究过程中，有1名患者在安装过程中需要通气支持治疗，但是所有的患者在平均3年的随访后都是存活的。期间有3名患者成功地进行了原位心脏移植，9名患者脱离了静脉强心治疗。患者们的左室容积减小，而射血分数增加。而且患者们安装后没有记录到除颤器源性休克，有1名患者发生的心室快速性心律失常也在除颤器的抗快速心律失常功能下恢复。
Cardiac resynchronization helpful in end-stage heart failure
NEW YORK (Reuters Health) - Cardiac resynchronization therapy can be effective in patients with advanced inotrope-dependent end-stage heart failure, researchers report in the July issue of the American Journal of Cardiology."Although bi-ventricular pacemakers for cardiac resynchronization have revolutionized the treatment of heart failure," lead investigator Dr. Bengt Herweg told Reuters Health, "their use in end-stage patients who are dependent on intravenous drugs has been controversial."Dr. Herweg of the University of South Florida College of Medicine, Tampa and colleagues studied 10 patients, mean age 55 years, with New York Heart Association Class IV heart failure receiving intravenous inotropic support with dobutamine or milrinone. The patients had a CRT (cardiac resynchronization therapy) cardioverter-defibrillator device implanted.One patient required ventilatory support during implantation, but at a mean of almost 3 years later, all patients were alive. Three patients underwent successful orthotopic cardiac transplantation. Nine of the patients were able to discontinue IV inotropic therapy. Moreover, LV volumes decreased and LV ejection fractions increased.No implantable defibrillator shocks were recorded, and anti-tachycardia therapy for ventricular tachyarrhythmias was administered in one patient."Our report demonstrates that it is never too late and that even the sickest end-stage patients with little hope can benefit from this therapy," concluded Dr. Herweg.
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