Comparison of Echocardiographic and Electrocardiographic Mapping for Cardiac Resynchronisation Therapy Optimisation.

Comparison of Echocardiographic and Electrocardiographic Mapping for Cardiac Resynchronisation Therapy Optimisation. Cardiol Res Pract. 2019;2019:4351693 Authors: Pereira H, Jackson TA, Claridge S, Behar JM, Yao C, Sieniewicz B, Gould J, Porter B, Sidhu B, Gill J, Niederer S, Rinaldi CA Abstract Study hypothesis: We sought to investigate the association between echocardiographic optimisation and ventricular activation time in cardiac resynchronisation therapy (CRT) patients, obtained through the use of electrocardiographic mapping (ECM). We hypothesised that echocardiographic optimisation of the pacing delay between the atrial and ventricular leads-atrioventricular delay (AVD)-and the delay between ventricular leads-interventricular pacing interval (VVD)-would correlate with reductions in ventricular activation time. Background: Optimisation of AVD and VVD may improve CRT patient outcome. Optimal delays are currently set based on echocardiographic indices; however, acute studies have found that reductions in bulk ventricular activation time correlate with improvements in acute haemodynamic performance. Materials and methods: Twenty-one patients with established CRT criteria were recruited. After implantation, patients underwent echo-guided optimisation of the AVD and VVD. During this procedure, the participants also underwent noninvasive ECM. ECM maps were constructed for each AVD and VVD. ECM maps were analysed offline. Total ventricular activ...
Source: Cardiology Research and Practice - Category: Cardiology Authors: Tags: Cardiol Res Pract Source Type: research

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Approximately one third of patients with reduced left ventricular ejection fraction (LVEF) also have electrical mechanical dyssynchrony manifested as widened QRS durations on surface electrocardiogram [1]. The dyssynchronous contraction of the ventricle results in reduced efficiency of cardiac output, functional diastolic mitral regurgitation, and unfavorable progressive remodeling of both the left and right ventricles [2 –4]. Furthermore, QRS prolongation is a significant predictor of clinical deterioration, with increased prevalence of severe mitral regurgitation and increase risk for ventricular tachyarrhythmias, ...
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Abstract The electrocardiogram (ECG) has been reinvigorated by the identification of electrical alterations that were not definitely clarified before. In this context, and mainly regarding the definition of arrhythmogenic substrates, the association of the ECG with the vectorcardiogram (VCG) has gathered much more information about the cardiac electrical phenomena, thus allowing us to differentiate potentially fatal cases from benign ones. Obtaining a VCG concomitantly with the performance of an ECG has led to a significant gain in the definition of extremely sophisticated pathologies, which function suffer some type of st...
Source: Arquivos Brasileiros de Cardiologia - Category: Cardiology Source Type: research
AbstractBackgroundThere is no consensus in the literature regarding what the responsible mechanism of left ventricular dyssynchrony is; septal dyskinesia or late movement of left ventricle (LV) lateral wall. We aim to evaluate the abnormal systolic motion in each myocardial segment and the improvement of LV systolic function with pulsed tissue Doppler Imaging (TDI) in patients undergoing cardiac resynchronization therapy (CRT) with left bundle branch block (LBBB).Methods26 patients undergoing CRT implantation with LBBB, wide QRS duration ( ≥120 ms), low ejection fraction (EF) (
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
ConclusionPatients with ALBBB may have a favorable echocardiographic response to CRT and display similar survival rates to typical LBBB. This subgroup of IVCD should be considered for CRT.Condensed abstractAtypical left bundle branch morphology defined as QS or rS in lead V1, broad R waves in lead I, and aVL but with QS or rS in V5 –V6 is associated with favorable echocardiographic response to CRT and displays similar survival rates to typical LBBB patients.
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
CONCLUSION: In our first Asian-Pacific real-world data, automated dynamic CRT optimization showed comparable efficacy to conventional methods regarding clinical outcomes and electromechanical remodeling. PMID: 31293111 [PubMed - in process]
Source: J Korean Med Sci - Category: General Medicine Authors: Tags: J Korean Med Sci Source Type: research
Peripartum cardiomyopathy (PPCM) is a potentially life ‐threatening condition typically presenting as heart failure with reduced ejection fraction (HFrEF) in the last month of pregnancy or in the months following delivery in women without another known cause of heart failure. This updated position statement summarizes the knowledge about pathophysiolo gical mechanisms, risk factors, clinical presentation, diagnosis and management of PPCM. As shortness of breath, fatigue and leg oedema are common in the peripartum period, a high index of suspicion is required to not miss the diagnosis. Measurement of natriuretic peptides,...
Source: European Journal of Heart Failure - Category: Cardiology Authors: Tags: Position Paper Source Type: research
Conclusion: While LVEDD, LVEF, 6MWD, and NYHA were significantly improved in ECHO, ECG, and QuickOpt at 6 months, there were no significant improvements in any of the groups at 12, 24, and 48 months. These findings suggested that the long-term effect of the four CRT methods for heart failure was not significantly different.Cardiology
Source: Cardiology - Category: Cardiology Source Type: research
AbstractUp to one-third of patients selected by current guidelines do not respond to cardiac resynchronization therapy (CRT), the aim of this study was to find out novel analytical approaches to improve pre-implantation CRT response prediction. Among 31 pre-implantation features of clinical, laboratory, electrocardiography (ECG), and echocardiography variables in a consecutive cohort of patients receiving a first-time CRT device(CRT-pacemaker or CRT-defibrillator), we developed a machine learning (ML) model with three classification algorithms (support vector machines (SVM),K nearest neighbors, and random subspaces) with t...
Source: The International Journal of Cardiovascular Imaging - Category: Radiology Source Type: research
Cardiac resynchronisation therapy (CRT) has been a cornerstone in the treatment of select advanced heart failure cases since its introduction to our armamentarium in the early 2000s.1 Indeed, 30 –60% of advanced heart failure patients exhibit evidence of dyssynchrony, when defined electrocardiographically or mechanically.2 –4 The latter is a consequence of the former. CRT has several unique features, summarised inTable 1.
Source: Radcliffe Cardiology - Category: Cardiology Authors: Source Type: research
ConclusionsCongestive heart failure is a rare complication in acromegaly-induced cardiomyopathy (occurs in only 3% of patients). Early diagnosis and treatment with curative drugs more than cardiovascular implantable electronic devices might lead to better surgical outcomes in this group of patients.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research
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