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慢性心衰的器械治疗新技术主要集中在改善电-机械传导和改善心脏机械结构两方面。改善电-机械传导方面,心脏再同步化治疗(cardiac resynchronization therapy,CRT)已成为合并心室内传导阻滞的中、重度慢性心力衰竭患者的标准疗法。但是近30%的CRT无反应是临床希望改善疗效的努力方向,新技术主要在于增加反应率,包括多位点起搏、左室心内膜起搏、无导线左室心内膜起搏,以及心衰肺阻抗监测。另外,心肌收缩力调节器(cardiac contractility modulation,CCM)自2001年植入以来也得到越来越多的临床应用。改善心脏机械结构领域,瓣膜修复和左室辅助装置的进展近年被较多提及。慢性心衰器械治疗的新技术近几年发展迅速,特别是新工具的应用,使得手术更加便捷、手术更加微创。相信随着越来越多临床试验的进展,新技术的应用将越来越广泛,心衰治疗的疗效将得到进一步改善。
New technologies for the treatment of chronic heart failure devices focus on improving electrical-mechanical transmission and improving the mechanics of the heart. Cardiac resynchronization therapy (CRT) has become the standard treatment for patients with moderate-to-severe chronic heart failure with ventricular conduction block in improving electrical-mechanical conduction. However, nearly 30% of CRT non-response is clinical efforts to improve the efficacy of the direction of the new technology is mainly to increase the response rate, including multi-site pacing, left ventricular endocardial pacing, non-lead left ventricular endocardial pacing, And heart failure pulmonary impedance monitoring. In addition, cardiac contractility modulation (cardiac contractility modulation, CCM) since 2001 has also been more and more clinical applications. In the field of improving the mechanical structure of the heart, the progress of valve repair and left ventricular assist device has been mentioned more in recent years. New technologies for the treatment of chronic heart failure have developed rapidly in recent years, especially the application of new tools, making the operation more convenient and the operation more minimally invasive. Believe that with the progress of more and more clinical trials, the application of new technologies will become more and more widespread, and the curative effect of heart failure treatment will be further improved.