CRT WITH BETA-BLOCKER ON HOME MONITORING — ONE CASE REPORT
Background: Cardiac resynchronization therapy (CRT) has been used to treat the heart failure for enlarged left ventricle with low EF% and LBBB effectively. Home monitoring could be used to monitor and optimize CRT with β-blocker.
Method: A CRT was implanted to the male patient, aged 70 years, with dilated cardiomyopathy and heart failure (LVDd=65mm, EF=43%, LBBB and QRS=175ms ) on September 20 of 2012. CRT combined medications such as β-blocker and ACEI have been used to improve the patient’s condition and it has been home-monitored continuously.
Fig. 80.1 PVC and VT increased from 26 to 29 of November for b-blocker being stopped, and the ventricular arrhythmia has been controlled again since the medication being taken again.
Results: The patient’s condition had been improved by CRT and medications gradually. But in the end of November, 2012, the heart rate was increased and PVC and ventricular runs reappeared more frequently, which would be dangerous to the patient. The abnormality was found and warned by the home monitoring in time. On the warning, the doctor interviewed the patient on call and made it clear that the β-blocker had been stopped by the patient himself for several days. The important medication of β-blocker was reused on the doctor’s advice. The ventricular arrhythmia has been controlled again and the CRT works well, which improve the patient’s condition (fig. 80.1.).
Conclusion: Both CRT and β-blocker may be significant to the patients of heart failure and home monitoring is helpful to both of the patients and doctors.