Hội Tim mạch học Việt Nam CRT bao cao

PRIMARY RESULTS OF CRT FOR HEART FAILURE WITH QRS ≥150 ms IN VIETNAM HEART INSTITUTE Phạm Quôc Khánh, MD.PhD et al Vietnam Heart Institute Background Heart Failure (HF) Definition A complex clinical syndrome in which the heart is incapable of maintaining a cardiac output adequate to accommodate metabolic requirements and the venous return New York Heart Association Functional Classification Class I: No symptoms with ordinary activity Class II: Slight limitation of physical activity Comfortable at rest, but ordinary physical activity results in fatigue, palpitation, dyspnea, or angina Class III: Marked limitation of physical activity Comfortable at rest, but less than ordinary physical activity results in fatigue, palpitation, dyspnea, or anginal pain Class IV: Unable to carry out any physical activity without discomfort Symptoms of cardiac insufficiency may be present even at rest HF Classification: Evolution and Disease Progression • Four Stages of HF (ACC/AHA Guidelines): Stage A: Patient at high risk for developing HF with no structural disorder of the heart Stage B: Patient with structural disorder without symptoms of HF Stage C: Patient with past or current symptoms of HF associated with underlying structural heart disease Stage D: Patient with end-stage disease who requires specialized treatment strategies Hunt, SA, et al ACC/AHA Guidelines for the Evaluation and Management of Chronic Heart Failure in the Adult, 2001 ` Background • Phương pháp tái đồng co bóp tim CRT đề cập vào đầu năm 1990s • Được FDA chấp nhận: 2001 • Được phân loại theo mức chứng IIA theo ACC; AHA; North American Society of Pacing and Electrophysiology Heart Rhythm Society guideline sử dụng máy tạo nhịp dụng cụ chống loạn nhịp tim (2004) MUSTIC: CRT vs no pacing, 58 bn NYHA III, EF60mm, 6-min walk 150 ms: - Reduced progression of heart failure - Reduced ventricular dimension and improved LV systolic function THANK YOU FOR YOUR ATTENTION ... đặt CRT: 412 bn • Blốc nhánh phải đặt CRT: 162 bn 60 50 40 30 20 10 LBBB RBBB Am J Cardiol 2009;103:238 Consuming time and fluoroscopy time in procedures Fluoroscopy Cosuming time (minutes) time(minutes)... chống loạn nhịp tim (2004) MUSTIC: CRT vs no pacing, 58 bn NYHA III, EF60mm, 6-min walk 150 ms: