On average, lao bo has a heart failure attack every 2-3 months, has been admitted to the hospital for 15 times, and is breathless with a little movement every day, is there still a "way to live"?
On March 22, a reporter from Guangzhou Daily Xinhuacheng learned from Sun Yat-sen Memorial Hospital of Sun Yat-sen University that the team of Professor Chen Banxin and Professor Zhou Shuxian of the Department of Cardiology of the hospital recently successfully completed the cardiac contractility regulator implantation for the old man who suffered from stubborn heart failure, which helped the old man's heart beat.
This is also the first batch of cardiac contractility regulator implantation in China and the first case in Guangzhou, marking a new breakthrough in the hospital's cardiovascular interventional diagnosis and treatment technology.
Heart failure is difficult to return The effect of implanting ICD is not good
The patient is a 78-year-old elderly man, who has sought medical treatment in the past 3 years due to ischemic cardiomyopathy and repeated heart failure attacks, and the number of heart failure re-admissions has reached 15 times, and there is obvious shortness of breath in daily activities.
In the past year, he went to the heart failure center of Sun Yat-sen Memorial Hospital of Sun Yat-sen University for standardized management, and after optimizing drugs, blood revascularization and other treatments, although the symptoms have eased, he still has heart failure once every 2-3 months. Recent re-examination of cardiac ultrasound showed that Lao Bo's cardiac EF (ejection fraction) was still as low as 32%, and Holter electrocardiogram showed frequent multi-type ventricular early and non-sustained ventricular rate. This means that sudden cardiac death may kill him in minutes.
To save him, doctors placed him in a single-chamber ICD (implantable cardioverter defibrillator). This is the most effective and indispensable means of preventing sudden cardiac death, but for this old man, the symptoms have not improved significantly.
Under the guidance of Professor Wang Jingfeng, Chairman-Designate of the Electrophysiology and Pacing Branch of the Chinese Medical Association and Director of the Department of Cardiovascular Medicine of Sun Yat-sen Memorial Hospital of Sun Yat-sen University, Professor Chen Banxin, Professor Zhou Shuxian and Associate Professor Mai Yiting comprehensively analyzed Lao Bo's condition and recommended the implantation of a new cardiac contractility regulator for treatment.
Precise treatment The heart is assisted by two "devices"
After careful preparation by the team, the surgical process was very smooth and minimally invasively completed under local anesthesia, which took about 1 hour.
During the operation, the doctor team fixed two active electrodes at the upper and lower intervals of the right ventricle, more than 2 cm apart, and verified by testing that the electrodes were accurately implanted in the area with the best effect. To ensure that the cardiac contractility regulator signal does not interfere with the ICD's defibrillation electrodes when it is sent, after connecting the cardiac contractility regulator, the doctor performs a cross-perception test during the operation. After the parameter adjustment, the cardiac contractility regulator and icd can work normally, which helps the elderly's heart beat.
After the operation, the patient recovered well and could get off the ground the next day and walk slowly in the ward.
Contrast shows successful implantation of a cardiac contractility regulator
Group photo of the surgical team
Patients with heart failure with narrow QRS waves have a new "way to live"
Professor Chen pointed out that icd is a first-line treatment plan for patients with heart failure with decreased EF (ejection fraction), which can reduce the mortality of patients by reducing sudden cardiac death. However, for patients with severe heart failure, especially those who still have repeated episodes of heart failure after standardized treatment, it is not enough to prevent sudden death, but also to improve the quality of life of patients.
Patients with wide ECG QRS waves can improve their symptoms through cardiac resynchronization, while patients with narrow QRS waves, who previously lacked effective instrumental therapy, now have a new way for them to be treated.
The principle of action of the cardiac contractility regulator is to implant a stimulation electrode into the patient's right ventricular septum through minimally invasive surgery, releasing strong electrical stimulation during the absolute refractory period of cardiac contraction. This electrical stimulation does not change the patient's heart rhythm, but it can improve the calcium regulation of the heart muscle through a series of signaling pathways, and enhance the ability of the heart to contract without increasing energy consumption, thereby improving the heart function of patients with heart failure.
It is understood that this treatment regimen is currently mainly suitable for narrow QRS waves (
Diagram
Text/Guangzhou Daily, Xinhua city Reporter: Ren Shanshan Correspondent: Huang Rui
The picture is provided by the hospital
Guangzhou Daily Xinhuacheng Editor: Li Jin