Abstract

MUNERA, Ana G et al. Heart resynchronization therapy: experience, clinical follow-up and optimization of the device with echocardiography. Rev. Col. Cardiol. [online]. 2007, vol.14, n.2, pp.67-77. ISSN 0120-5633.

Antecedents: in patients with advanced heart failure, functional class III-IV, mortality reaches 50% at one year and 80% at two years. Some remain asymptomatic and have a poor functional state, regardless of the pharmacologic treatment. Heart resynchronization therapy is a therapeutic alternative that improves hemodynamic and symptoms in these patients. Objective: to analyze the experience in the management of heart failure with heart resynchronization therapy devices with or without cardio defibrillator. Methodologic design: an intervention study without aleatory patients' assignment, with evaluation before and after the intervention. Results: the cohort was constituted by 82 patients. 73% were men. Mean age was 65.4 ± 11.9 years. The etiology was non-ischemic in 50 patients and ischemic in 32. Mean initial ejection fraction was 19.4%± 11.7%. Initial functional class was class III - IV in 85% of cases and all patients received optimal medical treatment. During the follow-up, it was observed improvement of functional class, diastolic function, diastolic diameter of left ventricle, ejection fraction, mitral insufficiency, left atrial area, systolic lung pressure, synchrony parameters and myocardial function index with statistical significant difference in relation to the initial value (p<0.05). Survival at 44 months was 72%. Conclusion: the experience with heart resynchronization therapy and clinical and echocardiographic follow-up of the studied patients is similar to that found in other studies described in the literature.

Keywords : heart resynchronization therapy; functional class; optimization and follow-up of the device; ejection fraction; mitral insufficiency.

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