Boston Scientific 's New Defibrillators Really Are Smarter
A suite of sensors designed to make implantable defibrillators smarter received a boost of support this week in the form of a late-breaking clinical trial presentation at the Heart Failure Society of America's annual scientific meeting in Dallas. New data confirmed that Boston Scientific's HeartLogic Diagnostic, which is slated for commercial release later this year as part of a new line of implantable heart devices, accurately enhanced the ability to classify patients at high or low risk of a future heart failure event. The Multisensor Chronic Evaluation in Ambulatory Heart Failure Patients (MultiSENSE) trial showed that the HeartLogic Diagnostic significantly expanded the ability of a baseline blood test to identify when patients were at an elevated risk of a heart failure event. The combination of the HeartLogic Diagnostic with a baseline NT-proBNP measurement accurately identified when patients within varying risk groups were at 23 to 50 times increased risk of a heart failure event. Boston Scientific said the new tool provides continuous measurement of a patient's heart failure by combining data from sensors evaluating heart sounds, respiration rate and volume, thoracic impedance, heart rate and activity. Current clinical guidelines recommend the use of a blood test to measure natriuretic peptides BNP or NT-proBNP in order to diagnose heart failure or determine disease severity. However, the company said the blood test can only reflect a snapshot...
In conclusion, our case showed a strong beneficial effect of Sacubitril/Valsartan on reverse remodeling and LVEF beyond the benefits of concomitant optimal medical therapy. This result is particular noteworthy because it was obtained although patient wasn't able to reach the full dose of the drug. Physician should always consider this drug effect when more demanding therapeutic strategies are needed for their HF patients. PMID: 30894032 [PubMed - as supplied by publisher]
Most cardiac implants, such as pacemakers and AICDs, are designed to correct the underlying heart’s rhythm, and synchronize atrial and ventricular contractions. That’s how these devices can improve cardiac performance in people with heart...
The objective of this study was to evaluate the relationship between electrocardiogram (ECG) parameters and LVPET in patients with CRT.MethodsIt was an observational, prospective, and monocentric study. From May 2017 to October 2017, all patients who underwent CRT with left quadripolar lead in Rouen University Hospital were included. LVPET was evaluated by echocardiography and defined as the time between the beginning of the QRS and the beginning of pulsed Doppler signal positioned in left ventricular outflow tract in apical view. The following parameters on 12-leads ECG were assessed: QRS width in V3, sum of QRS amplitude...
Cardiac resynchronization therapy (CRT) improves quality of life and survival in patients with heart failure, but it has not been rigorously investigated in LVAD patients. Furthermore, the effects of different pacing strategies on hemodynamics in LVAD recipients is unknown.
We present the full study cohort of the first prospective study evaluating outcomes with right ventricular (RV) vs biventricular (BiV) pacing in LVAD patients.
Exercise-induced left bundle branch block (LBBB) is rarely observed in exercise testing, and usually implies a worse prognosis. Cardiac resynchronization therapy (CRT) is well validated in patients with heart failure with reduced ejection fraction (HFrEF) and LBBB. Although the indications of CRT do not include exercise-induced LBBB, the functional impairment secondary to dynamic electromechanical dyssynchrony could potentially be improved with CRT.
Cardiac resynchronization therapy (CRT) has been shown to shorten QRS duration (QRSd) and improve ejection fraction (EF) in adults with congenital heart disease (ACHD) and children with heart failure with reduced ejection fraction (HFrEF). It is not known whether CRT confers a survival benefit. We sought to determine whether CRT is associated with longer transplant-free survival after adjusting for patient factors.
ABSTRACTBackground and aimsPatients with moderate ‐to‐severe chronic kidney disease (CKD) are underepresented in clinical trials of cardiac resynchronization therapy (CRT)‐defibrillation or CRT‐pacing (CRT‐P). We sought to determine whether outcomes after CRT‐D are better than after CRT‐P over a wide spectrum of CKD.Methods and resultsClinical events were quantified in relation to pre ‐implant estimated glomerular filtration rate (eGFR) after CRT‐D (n = 410 [39.2%]) or CRT‐P (n = 636 [60.8%]) implantation. Over a follow‐up period of 3.7 years (median, interquartile range: 2.1‐5.7), the eGFR
Cardiac resynchronization therapy (CRT) improves mortality, morbidity and quality of life in selected heart failure patients with severe left ventricular ejection fraction impairment. However, between 20% and 40% of device recipients do not benefit clinically from CRT. Indeed, some anatomical and technical difficulties are related to the coronary venous implantation site via the coronary sinus (CS). Additionally, electrical constraints have been described and CS does not always correspond to the optimal LV lead position.
ConclusionDaily multiparameter telemonitoring has a potential to reduce clinical endpoints in patients with chronic systolic heart failure both in ICD and CRT-D subgroups. The absolute benefit seems to be higher in higher-risk populations with worse prognosis.