Background: A lot of clinical studies have shown that, cardiac resynchronization therapy (CRT) in a combination of optimal medical therapy authentically improves quality of a life and increases life expectancy of patients with heart failure (HF).
Background: To demonstrate our experience of cardiac resynchronization therapy (CRT) usage and evaluate the effectiveness of CRT with the help of implantable CRT-devices in patients with heart failure.
Methods: Since 2010 to 2012 have been implanted 55 CRT devices to patients with HF (age 59±5,7; 24 female). 49 patients had HF III NYHA class, and the remaining patients had IV ambulatory class of NYHA. 37 patients’ HF has been caused by ischemic cardiomyopathy, and other cases of dilated cardiomyopathy. In every case left ventricular (LV) lead was implanted successfully into post lateral coronary vein. All patients took an optimal medical therapy. The SF-36 survey was used to evaluate the quality of life of the patients.
Results: Postoperatively, patients received an ambulatory monitoring. Testing and selection of optimal parameters for biventricular pacing were performed regularly, taking into account the subjective feelings and exercise tolerance. AV-delay parameters were set considering the optimal AV-synchronization. Evaluation of intra-cardiac hemodynamics was performed using trans-thoracic echocardiography. According to echocardiography data, intra-cardiac hemodynamics has significantly improved after 6,3 ± 4,5 months: LVEF increased from 31±5,2% to 42±3,7%, LVED volume decreased from 257,8±45,2 ml to 214,5±23,8 ml, LVES volume decreased from 197,5±23,9 ml to 144,6±17,1 ml, the severity of mitral regurgitation decreased from 2,5±0,72 to 1,6±1,17 and tricuspid regurgitation decreased from 2,3±0,37 to 1,7±0,91. The functional class of patients’ HF improved to NYHA class II in all cases.
Conclusions: Biventricular resynchronization pacing in patients with chronic HF, with the optimal medical therapy being chosen, markedly improves heart functions by eliminating ventricular dyssynchrony, accompanied with a decrease in the functional class of HF and improvement of the patients’ quality of life.