MODERN APPROACHES TO THE TREATMENT OF VENTRICULAR DESYNCHRONY: THE STATE OF THE PROBLEM IN THE WORLD AND THE ACHIEVEMENTS OF THE ODESSA CARDIOLOGICAL SCHOOL
Keywords:
heart failure, ventricular desynchrony, artificial rhythm driver, biventricular cardiac stimulationAbstract
The analysis of the state of development according to the data of the literature is carried out, the main priority directions of the solution of the problem of optimization of treatment of patients suffering from cardiac failure with ventricular disinchrony were studied. The study showed that the use of biventricular pacing can improve the tolerance to physical activity and normalize hemodynamic parameters. The average score of a test with a 6-minute walk was (277.5±12.5) m, the time of restitution after exercise — (32.3± ±3.7) seconds. In an ECG study in all patients, extension of the QRS complex was determined on average to (131±7) ms. Before treatment, the mean values of final diastolic size of left ventricle were (7.3±0.3) cm, and final systolic size — (6.2±0.2) cm, which corresponds to ejection fraction of (30.5±2.7)%. After the installation of artificial rhythm driver, the FDC decreased to (6.5±0.2) cm, while FSS decreased to (4.9±0.3) cm, which corresponds to ejection fraction (48.3±4.3)%. The described changes were accompanied by increased tolerance to physical activity — up to (277.5±12.5) m based on the results of a 6-minute walk test. Perspectives of using biventricular cardiostimulation in patients with ventricular desynchrony are considered.
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