Response to Cardiac Resynchronization Therapy in Non ‐ischemic Cardiomyopathy is Unrelated to Medical Therapy

IntroductionCurrent guidelines recommend at least three months of guideline ‐directed medical therapy (GDMT) for patients with a new onset of nonischemic cardiomyopathy (NICM) and left bundle branch block (LBBB) prior to cardiac resynchronization therapy (CRT). For patients who do not receive optimal GDMT, response to CRT is unknown.Materials and MethodsPatients with NICM and LBBB with QRS> 120 ms were identified among all patients who underwent CRT. Patients who received GDMT for> three months before CRT were compared to those who did not. Among 38 patients who met inclusion criteria, 24 received optimal GDMT prior to implantation (Group 1) and 14 did not (Group 2).ResultsQRS narrowing occurred in Group 1 (160 ± 9 ms to 138 ± 20 ms, P=0.001) and Group 2 (160 ± 17 ms to 139 ± 30 ms, P=0.021). LVEF improvement occurred in Group 1 (21.3 ± 5.9% to 34.4 ± 13.9%, P
Source: Clinical Cardiology - Category: Cardiology Authors: Tags: CLINICAL INVESTIGATIONS Source Type: research

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CONCLUSIONS: The degree of reverse remodelling was larger in patients with leads situated in a scar-free LCR. In patients with leads situated within scar there was a neutral effect on reverse remodelling, which can be caused both by higher scar burden or lead position. These findings demonstrate the feasibility of a CMR work-up and potential benefit in ICM patients undergoing CRT. PMID: 31953775 [PubMed - as supplied by publisher]
Source: Netherlands Heart Journal - Category: Cardiology Authors: Tags: Neth Heart J Source Type: research
AbstractIndications of cardiac resynchronization therapy (CRT) do not include exercise ‐induced left bundle branch block, but functional impairment could be improved with CRT in such cases. A 57‐year‐old woman with idiopathic dilated cardiomyopathy (ejection fraction 23%) presented with New York Heart Association Class IV and recurrent hospitalizations. During heart transplant e valuation, a new onset of intermittent left bundle branch block was observed on the cardiopulmonary exercise test. CRT was implanted, and 97% resynchronization rate was achieved. In 12 month follow‐up, both clinical and prognostic exercise ...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Case Report Source Type: research
AbstractIntroductionWe investigated whether pacing ‐induced electrical dyssynchrony at the time of cardiac resynchronization therapy (CRT) device implantation was associated with chronic CRT response.Methods and resultsWe included a total of 69 consecutive heart failure patients who received a CRT device. Left (LVp ‐RVs) and right (RVp‐LVs) pacing‐induced interlead delays were measured intra‐operatively and used to determine if there was paced left ventricular (LV) dyssynchrony (PLVD), defined as present when LVp‐RVs is larger than RVp‐LVs. CRT response was defined as a reduction in LV end‐systol ic volume ...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Why VTs have wide QRS complex? Brief answer: VT  usually presents with wide QRS tachycardia because it originates in ventricular myocardium, travels muscle to muscle instead of the normal conduction system. However, VTs need not be wide always, if it captures the conduction system early and more proximally it can be as narrow as SVT. Further reading: Only for cardiology fellows  Two empirical statements are made here. (The scientific chances of both being reasonably correct are fair) 80 % of wide QRS tachycardia by default is VT. That means 20 % of wide QRS is not VT. We all accept that. 80 % of narrow QRS tachy...
Source: Dr.S.Venkatesan MD - Category: Cardiology Authors: Tags: Uncategorized Source Type: blogs
The residual risk of ventricular arrhythmia (VA) after cardiac resynchronization therapy (CRT) implantation in patients with non-ischemic cardiomyopathy (NICM) remains difficult to evaluate. The impact of left ventricular (LV) wall thickness (WT) measured using computed tomography (CT) on the occurrence of VA after CRT implantation has never been investigated. In this pilot study, we examined the association of LVWT and the occurrence of VA in NICM patients receiving CRT. Thirty three patients with NICM scheduled for CRT underwent pre-procedural CT.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
The residual risk of ventricular arrhythmia (VA) after cardiac resynchronization therapy (CRT) implantation in patients with nonischemic cardiomyopathy (NICM) remains difficult to evaluate. The impact of left ventricular (LV) wall thickness (WT) measured using computed tomography (CT) on the occurrence of VA after CRT implantation has never been investigated. In this pilot study, we examined the association of LV WT and the occurrence of VA in NICM patients receiving CRT. Thirty three patients with NICM scheduled for CRT underwent preprocedural CT.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
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Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: COMPREHENSIVE REVIEWS Source Type: research
(Massachusetts General Hospital) Research has shown that treating chemotherapy-induced cardiomyopathy with commercially available cardiac resynchronization therapy (CRT) delivered through a surgically implanted defibrillator or pacemaker can significantly improve patient outcomes.
Source: EurekAlert! - Cancer - Category: Cancer & Oncology Source Type: news
This cohort study examines the association of cardiac resynchronization therapy with change in left ventricular ejection fraction (LVEF)among patients with chemotherapy-induced cardiomyopathy.
Source: JAMA - Category: General Medicine Source Type: research
A 59-year-old woman with a history of non-ischemic cardiomyopathy (ejection fraction of 30%) and obesity was admitted to internal medicine with palpitations. She had undergone uncomplicated cardiac resynchronization therapy with defibrillator (CRT-D) placement five days previously. At a skilled nursing facility, she experienced an intermittent pulsating feeling in her left chest several times per day. She described the feeling as the sensation of “somebody doing CPR from the inside.” She was referred to the emergency department for further evaluation.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research
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