Technological and Clinical Challenges in Lead Placement for Cardiac Rhythm Management Devices.
Technological and Clinical Challenges in Lead Placement for Cardiac Rhythm Management Devices. Ann Biomed Eng. 2019 Oct 01;: Authors: Albatat M, Bergsland J, Arevalo H, Odland HH, Bose P, Halvorsen PS, Balasingham I Abstract Cardiac disease is a leading cause of death worldwide. Disturbance in the conduction system of the heart may trigger or aggravate heart dysfunction, affecting the efficiency of the heart, and lead to heart failure or cardiac arrest. Patients may require implantable cardiac rhythm management devices (ICRMDs) to maintain or restore the heart rhythm. ICRMDs have undergone important improvements, yet limitations still exist, presenting important technological challenges. Most ICRMDs consist of a subcutaneous control unit and intracardiac electrodes. The leads, which connect the electrodes to the control unit, are usually placed transvenously through the subclavian veins. Various locations inside the heart are used for placement of electrodes, depending on the specific condition. Some of the limitations to effective pacemaker therapy are associated with placement and location of the leads. Various approaches have been developed to overcome these challenges, such as multi-site pacing and leadless solutions. This paper aims to review the state of the art for the selection of placement sites for pacemakers, implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy devices (CRT) devices and discuss potential technolog...
Conclusion: Our study showed that vitamin D deficiency has a significant impact in heart failure patients; it is an independent predictor of lack of midterm clinical response and long-term mortality in patients undergoing CRT. Therefore, monitoring vitamin D status of heart failure patients could be of clinical significance. PMID: 31737126 [PubMed - in process]
Authors: Singh A, Karnik R, Shah AN, Chutani S, Kantharia BK Abstract Aims: Response to cardiac resynchronisation therapy (CRT) in patients with heart failure depends on the degree of correction of electromechanical dyssynchrony between the left and right ventricles (LV, RV). It is not known whether chronic programming of interventricular (VV) intervals based on characterisation of myocardial strain at different pacing intervals performed acutely would have better long-term clinical outcomes. We hence aimed to evaluate this relationship between speckle tracking strain patterns and rates at different VV intervals an...
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A pacemaker-like device restored heart function in a group of cancer survivors — mostly women with breast cancer — who had suffered from heart failure as a result of chemotherapy, a study in the Journal of the American Medical Association (JAMA) reports.
(University of Rochester Medical Center) A pacemaker-like device restored heart function in a group of cancer survivors -- mostly women with breast cancer -- who had suffered from heart failure as a result of chemotherapy treatment, a study in the Journal of the American Medical Association (JAMA) reports.
This article includes also recently announced findings on the TRANSITION study which revealed that HFrEF therapy with ARNI might be safely initiated after an acute decompensated heart failure episode, including patients with heart failure de novo and ACEI/ARB na ïve, both hospitalised or shortly after discharge, in contrary to the PARADIGM-HF trial, where patients had to be administered a stable dose of an ACEI/ARB equivalent to enalapril 10 mg a day for at least 4 weeks before the screening.
ConclusionPosture and exercise have a smaller effect on AV timing compared with atrial pacing. However, individualized optimization and dynamic rate related changes may be needed to maintain optimal fusion with left ventricular (LV) stimulation.
Abstract BACKGROUND: The first European Cardiac Resynchronization Therapy (CRT) Survey, conducted in 2008-2009, showed considerable variations in guideline adherence and implantation practice. A second prospective survey (CRT Survey II) was then performed to describe contemporary clinical practice regarding CRT among 42 European countries. AIM: To compare the characteristics of French CRT recipients with the overall European population of CRT Survey II. METHODS: Demographic and procedural data from French centres recruiting all consecutive patients undergoing either de novo CRT implantation or an upgrade...
This study included 36 patients. At rest, AV intervals changed minimally with posture. With atrial pacing, AV interval immediately increased compared with sinus rhythm, with ARV slopes being 8.1 ±7.7, 8.8±13.4 and 6.8±6.5 milliseconds per beat per minute (ms/bpm) and ALV slopes being 8.2±7.7, 9.1±12.8, and 7.0±6.5 ms/bpm for supine, standing and sitting positions, respectively. As paced heart rate increased, ARV and ALV intervals increased more gradually with similar trends. Intervent ricular conduction times changed
CONCLUSIONS: Reactive ATP successfully and safely reduced AF burden, and was associated with a lower incidence of HF hospitalization in patients implanted with CRT devices. PMID: 31672258 [PubMed - as supplied by publisher]