Impact of Paced Left Ventricular Dyssynchrony on Left Ventricular Reverse Remodeling after Cardiac Resynchronization Therapy

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 ≥15%, 6 months after implantation. PLVD was associated with ischemic cardiomyopathy (ICM) (X²:8; P=0.005) but not with QRS morphology nor with pacing lead positions. In a univariate analysis, PLVD (OR:6.53; [95% CI, 2.2‐18.9]; P=0.001), atypical left bundle branch block (LBBB) (OR:3.3 ; [95% CI,1.2‐9.4];P=0.022), and ICM (OR:5.2; [95% CI, 1.6‐17];P=0.006) were associated with non‐response. In a multivariate analysis, both PLVD (OR: 9.74; [95% CI, 2.8‐33.9]; P
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: ORIGINAL ARTICLE Source Type: research

Related Links:

This study aimed to investigate eligibility, titration, and tolerability for Sac/Val in a real ‐world clinical setting.Methods and resultsThis retrospective cohort study consists of two parts. In Part 1 (eligibility study), all patients discharged from Sahlgrenska University Hospital due to HF were consecutively included during 1 year. Data from the patients' medical records were collected. Patients were adjudicated to be eligible based on European Society of Cardiology (ESC) criteria for angiotensin receptor neprilysin inhibitor (ARNI) with the exception of N ‐terminal (NT)‐proBNP levels. Patients who received
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
AbstractAimsEchocardiographic response after cardiac resynchronization therapy (CRT) is often lesser in ischaemic cardiomyopathy (ICM) than non ‐ischaemic dilated cardiomyopathy (NIDCM) patients. We assessed the association of heart failure aetiology on the amount of reverse remodelling and outcome of CRT.Methods and resultsNine hundred twenty ‐eight CRT patients were retrospectively included. Reverse remodelling and endpoint occurrence (all‐cause mortality, heart transplantation, or left ventricular assist device implantation) was assessed. Two response definitions [≥15% reduction left ventricular end systolic vo...
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article 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
This article is protected by copyright. All rights reserved.
Source: Journal of Cardiovascular Electrophysiology - Category: Cardiology Authors: Tags: COMPREHENSIVE REVIEWS Source Type: research
ConclusionsSARM predicts non ‐response to CRT and may help in the selection of CRT candidates.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
Left bundle branch block (LBBB) is a frequent finding in heart failure population, especially in patients with dilated cardiomyopathy (DCM). Traditionally, LBBB was considered rather as a consequence than as a cause of the myocardial disease. This assumption was reinforced by the fact LBBB is associated with poor prognosis. However, the observation of “hyper-responders” to cardiac resynchronization therapy (CRT) among patients with DCM and LBBB, have contributed to the emergence of the entity of LBBB-induced DCM [1].
Source: International Journal of Cardiology - Category: Cardiology Authors: Tags: Editorial Source Type: research
Conclusions: The clinical course of patients with ICM and DCM treated with CRT-D differs significantly during long-term follow-up, with increased mortality and incidence of ICD therapies in ICM patients. PMID: 31360179 [PubMed]
Source: Archives of Medical Science - Category: General Medicine Tags: Arch Med Sci Source Type: research
AbstractPurpose of ReviewThe purpose of this paper was to review the role of cardiac computed tomography (CCT) in both the diagnostic and management pathways of heart failure.Recent FindingsCT has an essential role in non-invasively excluding coronary artery disease but also can provide additional information that can aid the investigation of the patient presenting with heart failure. CT images provide high-quality information about cardiac structure and pericardium. Cardiac anatomical information, such as the location and size of coronary sinuses, can assist in lead placement in cardiac resynchronisation therapy. Cardiac ...
Source: Current Cardiovascular Imaging Reports - Category: Radiology Source Type: research
CONCLUSION: In our study, 27.6% of patients were super-responders, and a diagnosis of dilated cardiomyopathy, absence of a prior history of MI and prior RV apical pacing predicted a super-response to CRT. PMID: 31779862 [PubMed - in process]
Source: Indian Heart J - Category: Cardiology Authors: Tags: Indian Heart J 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
More News: Cardiac Resynchronization Therapy | Cardiology | Cardiomyopathy | Cardiovascular | Computers | Heart | Heart Failure