Myocardial strain characteristics at different interventricular pacing timings: implications for device programming and long-term clinical outcomes in patients with cardiac resynchronisation therapy.

Myocardial strain characteristics at different interventricular pacing timings: implications for device programming and long-term clinical outcomes in patients with cardiac resynchronisation therapy. Acta Cardiol. 2019 Nov 14;:1-10 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 and long-term clinical outcomes of programmed VV pacing in patients with CRT in a prospective, longitudinal follow-up study.Methods: We assessed echocardiographic effects, myocardial strain patterns and rates in acute settings at VV intervals; 'LV Off', 'VV0', 'VV60' and 'RV Off' to provide 'RV-only', 'simultaneous BiV', 'sequential LV-RV' and 'LV-only' pacing respectively in 338 patients (age, 67.5 ± 10.3 years; male, 70%) with CRT. Thereafter, devices were programmed chronically to VV60, and long-term clinical outcomes were assessed.Results: With VV0, VV60 and LV only pacing, LVEF improved to...
Source: Acta Cardiologica - Category: Cardiology Tags: Acta Cardiol Source Type: research

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Authors: Asgardoon MH, Vasheghani-Farahani A, Sherafati A Abstract Cardiac resynchronization therapy (CRT) is an effective treatment strategy for heart failure. However, some patients do not response properly to this treatment. In this review, the role of different biomarkers in predicting response to CRT is discussed. Some biomarkers including natriuretic peptides and inflammatory markers have promising results but further trials are needed for more evaluation. PMID: 31822259 [PubMed - as supplied by publisher]
Source: Current Cardiology Reviews - Category: Cardiology Tags: Curr Cardiol Rev Source Type: research
AbstractIntroductionSeveral automatic algorithms have developed to optimize timing cycle setting in cardiac resynchronization therapy (CRT). The present study aims to investigate whether the novel device ‐based SyncAV algorithm could elicit better synchrony and acute hemodynamic response.Methods and Results35 patients undergoing CRT implantation were prospectively studied. Device was programmed to three biventricular (BiV) pacing modes sequentially after procedure: QuickOpt algorithm (Mode I), SyncAV algorithm with default 50ms offset (Mode II), and SyncAV algorithm with optimized offset minimizing QRS duration (QRSd) (M...
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: DEVICE THERAPY Source Type: research
Low systolic blood pressure (SBP) is associated with increased mortality and heart failure in patients with left ventricular dysfunction. Data on the relation between SBP measured following cardiac resynchronization therapy implantation and subsequent clinical events are limited. We hypothesized that assessment of systolic blood pressure at 12 months after cardiac resynchronization therapy can be used to identify patients with increased risk for adverse cardiovascular outcomes. The study population comprised 1000 patients who underwent cardiac resynchronization therapy implantation in MADIT-CRT.
Source: The American Journal of Cardiology - Category: Cardiology Authors: Source Type: research
AbstractBackgroundIn order to better understand the concept of mechanical dyssynchrony, a promising hallmark of cardiac resynchronization therapy (CRT) response, we investigated its effect on regional myocardial metabolism and myocardial blood flow (MBF) in non-ischemic CRT candidates.ResultsThirty consecutive non-ischemic CRT eligible patients underwent static18F-FDG and resting dynamic13N-NH3 PET/CT.18F-FDG uptake and MBF for septal and lateral wall were analysed and septal-to-lateral wall ratios (SLR) were calculated. Based on the presence of mechanical dyssynchrony (septal flash and/or apical rocking) on echocardiograp...
Source: EJNMMI Research - Category: Radiology Source Type: research
ConclusionThis analysis from the European CRT Survey II overall shows good guideline adherence, high implantation success and a low rate of complications in daily practice. There are some regional differences in baseline characteristics, CRT indication, and procedural aspects. The use of remote monitoring in Germany lags behind other European countries.Graphic abstract
Source: Clinical Research in Cardiology - Category: Cardiology Source Type: research
AbstractNon-left bundle branch block (non-LBBB) remains an uncertain indication for cardiac resynchronization therapy (CRT). Non-LBBB includes right bundle branch block (RBBB) and non-specific LV conduction delay (NSCD), two different electrocardiogram (ECG) patterns which are not generally considered to be associated with LV conduction delay as judged by the invasive assessment of the Q-LV interval. We evaluated whether a novel ECG interval (QR-max index) correlated with the degree of LV conduction delay regardless of the type of non-LBBB ECG pattern, and could, therefore, predict CRT response. In 173 non-LBBB patients on...
Source: Journal of Interventional Cardiac Electrophysiology - Category: Cardiology Source Type: research
CONCLUSION: In a population of HF patients undergoing CRT, CD was independently associated with mortality and hospitalization for HF.RESUMO INTRODU ÇÃO: A terapia de ressincronização cardíaca (TRC) é uma modalidade terapêutica para pacientes com insuficiência cardíaca (IC). A eficácia desse tratamento para redução de eventos baseia-se em ensaios clínicos em que a população de pacientes com doença de Chagas (DC) é sub-representa da. OBJETIVO: Avaliar o prognóstico após TRC em uma populaç&...
Source: Revista da Associacao Medica Brasileira - Category: General Medicine Source Type: research
Background: Tpeak-Tend interval (TpTe), a measurement of transmural dispersion of repolarization (TDR), has been shown to predict ventricular tachyarrhythmia in cardiac resynchronization therapy with defibrillator (CRT-D) patients. However, the ability of TpTe to predict ventricular tachyarrhythmia and mortality for heart failure patients with a cardioverter-defibrillator (ICD) is not clear. The purpose of this study was to assess the predictive ability of TpTe in heart failure patients with ICD. Methods and results: We enrolled 318 heart failure patients treated after ICD. Patients were divided into 3 groups accordin...
Source: Medicine - Category: Internal Medicine Tags: Research Article: Observational Study Source Type: research
Abstract Permanent His bundle pacing (HBP) activates the ventricles through the normal conduction system and has become a useful technique for patients with a high ventricular pacing rate. Presently described is a case of drug-refractory atrial fibrillation (AF) with a high ventricular rate that was treated with atrioventricular (AV) node ablation and permanent HBP. A 62-year-old woman with persistent AF and a drug-refractory high ventricular response was referred for exercise intolerance and palpitation. She had a history of failed catheter ablation attempts and amiodarone toxicity. Permanent HBP and AV node abla...
Source: Turk Kardiyoloji Dernegi arsivi - Category: Cardiology Authors: Tags: Turk Kardiyol Dern Ars Source Type: research
AbstractPurpose of ReviewTo introduce the reader to the basics of pressure-volume (PV) analysis, its current role in management of heart failure and valvular disease, and the possibilities for future use.Recent FindingsThe recent introduction of FDA-approved miniaturized conductance catheters that can produce PV loops in the clinical setting has set the stage for the translation of this important research technique into clinical practice. The use of these catheters has shed important insights into the pathophysiology of many common conditions associated with heart failure including heart failure with preserved ejection fra...
Source: Current Cardiology Reports - Category: Cardiology Source Type: research
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