天津医药

天津医药 ›› 2019, Vol. 47 ›› Issue (1): 82-85.doi: 10.11958/20181205

• 临床研究 • 上一篇    下一篇

CRT-D治疗扩张型心肌病合并完全性左束支 传导阻滞超反应一例

谢清清 1，崔丽 2，曹月娟 2△   

  1. 作者单位：1天津中医药大学研究生院（邮编300193）；2天津市人民医院心脏内科 作者简介：谢清清（1991），女，硕士在读，主要从事心血管病研究 △通讯作者 E-mail: drcyj@aliyun.com
  • 收稿日期:2018-08-13 修回日期:2018-12-04 出版日期:2019-01-15 发布日期:2019-01-15
  • 通讯作者: 曹月娟 E-mail:drcyj@aliyun.com

A case of CRT-D in the treatment of dilated cardiomyopathy complicated with complete left bundle branch block hyperreactivity

,XIE Qing-qing1, CUI Li2，CAO Yue-juan2△   

  1. 1 Tianjin University of Traditional Chinese Medicine Graduate School, Tianjin 300193, China; 2 Department of Cardiology, Tianjin Union Medical Center △Corresponding Author E-mail: drcyj@aliyun.com
  • Received:2018-08-13 Revised:2018-12-04 Published:2019-01-15 Online:2019-01-15

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摘要： 报告1例扩张型心肌病合并完全性左束支传导阻滞患者，入院后给予强心、扩管、利尿、抑制心肌重构和改 善心肌代谢等治疗，住院过程中患者反复发作室颤，且心功能差，行心脏再同步化治疗除颤器（CRT-D）植入术，术后 患者症状明显改善，随访近2年，超声心动图示：左室舒张末内径由70 mm缩小到42 mm，左房内径由34 mm缩小到 30 mm，左室射血分数由0.35提高到0.62。患者一般状况良好，日常活动不受限制，为CRT-D超反应，由此推测出本 例患者取得超反应的原因可能是CRT-D纠正了传导阻滞导致的心脏进行性扩大。

关键词: 心肌病, 扩张型, 完全性左束支传导阻滞, 心脏再同步化治疗除颤器, 超反应

Abstract: A case of dilated cardiomyopathy complicated with complete left bundle branch block was reported. After admission, the patient was treated with cardiotonic, dilatation, diuresis, inhibition of myocardial remodeling, improvement of myocardial metabolism and so on. The patient was with recurrent ventricular fibrillation during hospitalization and poor heart function, and the patient's symptoms improved significantly after CRT-D (cardiac resynchronization therapy-defibrillator) implantation. Followed up for nearly 2 years, echocardiography showed that left ventricular end diastolic dimension reduced from 70mm to 42 mm, left atrium dimension reduced from 34 mm to 30 mm, and left ventricular ejection fraction increased from 0.35 to 0.62. The patient was generally in good condition and no restrictions on daily activities, which was the CRT-D hyperreactivity. The reason for this patient's hyperreactivity might be that CRT-D has corrected the progressive enlargement of the heart caused by conduction block.

Key words: cardiomyopathy, dilated, complete left bundle branch block, CRT-D, hyperreactivity