Design and rationale of the Impact of MultiPoint pacing in CRT patients with reduced RV-to-LV delay (IMAGE-CRT) study

Conclusion Reducing the nonresponder rate continues to be an important goal for CRT. If an increase in reverse remodelling can be achieved by MPP, this study supports the conduct of larger trials investigating the role of MPP on clinical outcomes in selected patients treated, right now, only with traditional CRT. Trial registration ClinicalTrials.gov, NCT02713308. Registered on 18 March 2016.
Source: Journal of Cardiovascular Medicine - Category: Cardiology Tags: Study design Source Type: research

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Cardiac resynchronization therapy (CRT) has been associated to left ventricle (LV) remodelling, reduction of functional mitral regurgitation (FMR) and clinical improvement in patients with heart failure and reduced ejection fraction (HFrEF). The prevalence of significant FMR in patients with LV dyssynchrony that are candidate to CRT is up to 40%. Current approach in patients with FMR undergoing CRT consists of re-evaluation of the amount of FMR following a waiting period of at least 3  months after the implant.
Source: International Journal of Cardiology - Category: Cardiology Authors: Source Type: research
Conclusions: CRT-D has higher greater cost-effectiveness across more subgroups in the indicated patient populations against as compared to OPT, ICD and CRT-P, from a US payer perspective. PMID: 32207659 [PubMed - as supplied by publisher]
Source: Journal of Medical Economics - Category: Health Management Tags: J Med Econ Source Type: research
Condition:   Heart Failure Interventions:   Procedure: Temporary pacing Study;   Radiation: Thoracic CT;   Diagnostic Test: Acute hemodynamic study;   Diagnostic Test: Non-invasive body surface mapping;   Diagnostic Test: Invasive catheter-based mapping Sponsors:   Guy's and St Thomas' NHS Foundation Trust;   King's College London Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
ConclusionsTherapy with CRT-D compared to CRT-P resulted in an additional gain of QALYs, but was more expensive. In addition, the ICER was subject to uncertainty, especially due to the uncertainty in the survival benefit. A randomised controlled trial and subgroup analyses would be desirable to further inform decision making.
Source: Applied Health Economics and Health Policy - Category: Health Management Source Type: research
Abstract BACKGROUND: The impact of left ventricular reverse remodeling (LVRR) on the prognosis of Chagas cardiomyopathy is unknown. The aim of this study was to determine whether the presence of LVRR can predict mortality in these patients. METHODS: From January 2000 to December 2010, the medical charts of 159 patients were reviewed. LVRR was defined as an increase of left ventricular ejection fraction (LVEF) and a decrease of left ventricular end-diastolic diameter (LVDD) by two-dimensional echocardiography. No patient underwent cardiac resynchronization therapy or required mechanical ventricular assistance....
Source: Cardiology Journal - Category: Cardiology Authors: Tags: Cardiol J Source Type: research
AbstractBackgroundCardiac resynchronization therapy(CRT) is an important and effective therapy for end ‐stage heart failure. Non‐response to CRT is one of the main obstacles to its application in clinical practice. Herein, we investigated the utilization of the optimization technique using NICOM based Mobil‐O‐Graph device which measures several circulation parameters non‐invasively.MethodsSeventy ‐five CRT non‐responder heart failure patients with an implanted CRT device were included. Patients were randomized equally to 3 groups: NICOM, echocardiographic and empirical optimization groups. After 3‐months of...
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
AbstractBackgroundPermanent right ventricular pacing (RVP) results in cardiac dyssynchrony that may lead to heart failure and may be an indication for the use of cardiac resynchronization therapy (CRT). The study aimed to evaluate predictors of outcomes in patients with pacing ‐induced cardiomyopathy (PICM) if upgraded to CRT.Methods115 patients, 75.0 years old (IQR 67.0 –80.0), were upgraded to CRT due to the decline in left ventricle ejection fraction (LVEF) caused by the long‐term RVP. A retrospective analysis was performed using data from hospital and outpatient clinic records and survival data from the natio...
Source: Pacing and Clinical Electrophysiology : PACE - Category: Cardiology Authors: Tags: DEVICES Source Type: research
Exercise oscillatory ventilation (EOV) is characterized by ventilatory control system instability with typical waxing and waning of tidal volume without interposed apnea during exercise.1 EOV has been observed in up to 50% of heart failure (HF) patients with similar frequency for those with either reduced2 or preserved3 left ventricular ejection fraction (LVEF). EOV has also been associated with increased mortality risk in HF patients with either reduced4 or preserved LVEF.3
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Source Type: research
ConclusionsIron deficiency is a negative predictor of effective CRT therapy as assessed by reverse cardiac remodelling and clinical response. Assessment of iron substitution might be a relevant treatment target to increase CRT response and outcome in chronic heart failure patients.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research
Conclusions: In the real-world population, significantly worse survival of ICM in comparison with NICM is observed. Ischemic heart failure etiology is a strong independent predictor of mortality. PMID: 32200617 [PubMed - as supplied by publisher]
Source: Polish Heart Journal - Category: Cardiology Authors: Tags: Kardiol Pol Source Type: research
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