The cardiac resynchronization therapy: indications and concept of clinical application for treat ment of patients with chronic cardiac failure


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Abstract

The cardiac resynchronization therapy is commonly considered as the stimulation of right and left heart ventricles synchronized with atrium rhythm to correct endocardiac conduction with purpose to eliminate mechanical dyssinchrony of heart. The main clinical effects of application of cardiac realignment therapy are manifested in increase of life span of patients with cardiac failure. The point of mechanism of cardiac realignment therapy is in synchronization (realignment) of atrium and ventricle contractions that makes it possible to enhance diastolic filling of ventricles and to decrease mitral regurgitation. The other point is in synchronization of movements of inter-ventricular septum with free wall of left ventricle. This process is followed by such hemodynamic effects as increase of rate of increment of pressure in left ventricle during isovolumic contraction (dp/dt), decrease of pressure of jamming in pulmonary artery, increase of indicators of systolic and pulse pressure. In the upshot, stroke and minute volume increases and pumping function of heart ameliorates. The amelioration of endocardiac hemodynamics results in increasing of dimensions of left ventricle. The so-called reverse remodelling of left ventricle occurs that in turn manifests in amelioration of clinical status of patient and dramatically delay progression of chronic cardiac failure.

About the authors

A. Sh Revishvili

The A.N. Bakulev research center of cardiovascular surgery of the Russian academy of medical sciences

отделение хирургического лечения нарушений ритма сердца

S. I Stupakov

The A.N. Bakulev research center of cardiovascular surgery of the Russian academy of medical sciences

Email: sergej.stupakov@yandex.ru
отделение хирургического лечения нарушений ритма сердца

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