[SCD-FORUM] 23E RE:：肥厚性心肌病衰竭期的女性患者――Dubner医师

[SCD Symposium]

亲爱的Hormoz Alizadeh：    如果你的病人患有完全性房 
室传导阻滞伴大量室性逸搏，当然得需要电刺激（起 
搏器）。如果存在心房活动，则提示需要植入双腔起 
博器。    考虑植入ICD时不需提及任何危险因素，除 
非你认为是有严重左室和右室功能不全的心肌病；另 
一方面，是否有植入CRT指征，则需要知道她是否存在 
左束支传导阻滞、你所提及的收缩功能不全是否指的 
是心室不同步、或者通过组织多普勒或其他诊断方法 
显示的不同步。明确心肌病诊断的情况下，如果没有 
心室不同步，我建议植入DDDR起搏器或者考虑双腔ICD。
此致﷒ 问候

Sergio Dubner医师

Sergio Dubner博士 科委会主席Dr. Edgardo Schapachnik组织会 
主席袁奕译


23E RE: A female with burned-out phase of HCM? Dr. DubnerDear Hormoz  
Alizadeh If your patient has complete AV block with wide ventricular  
escape,  surely she needs electrical stimulation. If there is atrial  
activity,  a dual chamber is indicated.You do not mention any risk  
factor to think about an ICD, unless you  assume this is a  
cardiomyopathy with severe LV and RV dysfunction,  and on the other  
hand, to indicate a CRT device it should be  interesting to know if  
she has LBBB, if the systolic dysfunction you  mention implies  
ventricular dyssynchrony, or if you can perform  tissue Doppler or  
any other diagnostic method that shows dysynchrony.If there is no  
dyssynchrony, I should go on with a DDDR pacemaker or  think about a  
dual chamber ICD in case you confirm a cardiomyopathy.Best  
regards,Sergio Dubner
--
Dr. Sergio Dubner
President of Scientific Committee

Dr. Edgardo Schapachnik
President of Steering Committee