臨床検査66巻3号

2022年03月発行

今月の特集 「心不全パンデミック」を迎え撃つ！ 心不全に対する治療

心不全に対する心臓再同期療法（CRT）

著者： 石川利之¹

所属機関： ¹横浜市立大学附属病院循環器内科

ページ範囲：P.276 - P.281

Point

●心不全例においてはしばしば左室収縮の協調性が失われている（dyssynchrony）．左室と右室をペーシングする心臓再同期療法（CRT）によって左室収縮の協調性が回復する．

●QRS幅の広い，特に完全左脚ブロックパターンを示す症例がCRTのよい適応となる．

●心不全は進行性の病態である．CRTをニューヨーク心臓協会（NYHA）Ⅰ〜Ⅱ度の早期の心不全から導入することで心不全の進行は抑制される．

●心不全症例は心室細動による突然死を起こすことがまれではない．CRTと植込み型除細動器（ICD）を組み合わせたCRT-Dが有効である．

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