give the thumbs-up! City six – City eight Medical Union experts MDT relay cooperation, huge heart rebirth!

On September 1, the city’s eighth hospital successfully completed the implantation of “biventricular synchronous pacemaker Crtd” for patients with huge heart disease in 170 days. After the operation, the pacemaker worked normally and the patient’s symptoms improved significantly. At present, he has been discharged from hospital. There was also a thank-you note. This operation is in a leading position in China, which provides a new and beneficial treatment for patients with dilated cardiomyopathy and severe heart failure. Mr. Zhong, 75, had a history of hypertension, renal insufficiency, type 2 diabetes and other basic diseases. In the past five years, he often felt chest tightness and shortness of breath after walking, and the distance of each walk became shorter and shorter. After diagnosis and treatment in the Department of Cardiology of eight hospitals, he was admitted to the hospital immediately. Pan Jingwei, chief physician and executive director of Cardiology Department, found that Mr. Zhong’s pulse oxygen was low, about 90% up and down, heart rate 93 beats / min, and shortness of breath in supine position. ECG showed complete left bundle branch block. In order to further clarify the diagnosis, Shen e, the chief physician and executive director of the ultrasound department, conducted a consultation. Transthoracic echocardiography was used to check the heart size, cardiac function, and valve regurgitation, so as to determine whether synchronous treatment can be performed and to predict the results of synchronous treatment. Echocardiography showed that the left ventricle was enlarged, with an end diastolic diameter of 77mm, which was much higher than the normal 55mm, and mitral regurgitation occurred Flow, cardiac systolic function was severely reduced, LVEF was 28%. In particular, the cardiac synchrony was carefully evaluated, which is an important link in the success of synchronization therapy. Cardiac motion was diffusely weakened, especially the movement was uncoordinated. Conclusion after evaluation, there are obvious asynchrony between atrioventricular, ventricular and indoor, and feedback to Director Pan Jingwei cardiogram report and determine the items Changes in cardiac parameters support synchronous therapy. All the examination results showed that the patient’s condition was serious and complicated, heart failure, renal failure, arrhythmia or sudden death risk. After the joint consultation of Cardiology, ultrasound medicine and Nephrology, the diagnosis was coronary heart disease, old myocardial infarction, chronic heart failure, chronic renal insufficiency and type 2 diabetes. The consultation results fully optimized the drug treatment, and suggested that patients should be implanted with three chamber pacemaker. In view of the fact that Mr. Pan Jingwei, director of the Department of internal medicine, was in critical condition, and the director of Department of internal medicine, Mr. Pan Jingwei, the director of the Department of internal medicine, was in charge of the operation of double ventricular pacemaker in Beijing hospital. After three hours of hard work, the operation was successfully completed. After adjusting the parameters, hemodynamics and electrophysiology of patients tended to be stable. After the operation, the patient was transferred to CCU. The ECG monitoring for two days showed that QRS was shortened from 205ms to 130ms. QRS shortening is a clear sign of CRT treatment, and the pacemaker works well. At present, Mr. Zhong has recovered and discharged from hospital. < / P > < p > it is mainly used in patients with chronic heart failure and cardiac systolic disharmony. When heart failure occurs, the compensatory capacity of the heart increases, and the myocardial movement of all parts of the heart cavity is not coordinated, resulting in further reduction of the myocardial contractile force. Just like a group of people rowing, if they move in the same pace and use the force in one place, they will move forward quickly. On the contrary, everyone will do their own work, and the strength will be dispersed and offset each other, and they can only rotate in the same place. Three chamber pacemaker can treat heart failure. Its working principle is to implant a lead in left ventricular lateral vein, right atrium and right ventricle respectively. By reasonably setting the pacing sequence and time of three lead wires, the heart muscle of failure can be re coordinated and contracted, so as to achieve the purpose of treating heart failure. Clinical indications of three chamber pacemaker: three chamber pacemaker can be implanted. AV interval and VV interval can be adjusted by external program control to correct posterior papillary muscle insufficiency, restore synchronous excitation of two ventricles, realize cardiac electromechanical resynchronization, reduce mitral regurgitation, reduce indoor shunt, increase cardiac output, improve cardiac function and reduce hospitalization rate Effective prevention of sudden cardiac death. Focus