Science & Healthcare

Introduction. The article presents an analysis of the effectiveness of cardiac resynchronization therapy with defibrillation in the treatment of patients with CHF, refractory to optimal drug therapy.

Purpose of the study: evaluate the efficacy and safety of CRT-D in patients with chronic heart failure.

Materials and methods of research: A retrospective study was conducted, involving 34 patients who had been implanted with the CRT-D system according to standard indications. Evaluation of the effectiveness of procedures was conducted on the basis of analysis of ventricular dyssynchrony revealed by ECG, echocardiography; both before and after the procedure (on the 7th day). Statistical analysis of the data (calculation of mean values, standard deviation, and correlation coefficient) was carried out using application packages Microsoft Excel, SPSS18.0.

Research results: The study included 34 patients, mean age 64,44 ± 9,95 years, while the proportion of men was 70,5%, women 29,5%. Initially, all patients had an advanced stage of CHF: II functional class was 26,5%, III FC 52.9%, IV FC 20,6%. All patients had heart failure of ischemic and non-ischemic (dilated cardiomyopathy) genesis – 88,2% and 11,8% respectively. Initially, the width of the QRS complex averaged 146,95 ± 20,54 ms. After the CRT-D, the QRS complex averaged 126,24 ± 12,92 ms. The mean fraction of the left ventricular ejection was 32,43 ± 11,52%, the average dynamics after the procedure was 37,14 ± 8,09%. During the analysis, no single intraoperative lethal case was detected. The total hospital mortality was 2.9% - 1 case, due to the initially severe decompensation of CHF.

Conclusions: Thus, the analysis showed a positive effect of CRT-D on the clinical status of patients with HF - a decrease in CHF’s FC of the majority of patients. In addition, a positive trend was observed in the rates of ventricular dissynchrony after CRT-D implantation as a shortening of the QRS interval by 16,1%, which is the most important indicator of its effectiveness. Already on the 7th day revealed the growth of left ventricular ejection fraction of 14,5%. An important fact is the absence of periprocedural complications and a high level of its safety.