Why is the clinical response to cardiac resynchronization better in LBBB patients?

ConclusionsThe declared outcome of the LBBB groups reflects inevitably the survival outcome of their non ‐ICM patients and not the intended outcome of patients with LBBB. CRT‐D in patients with different aetiologies of cardiomyopathy calls for separate evaluation.
Source: ESC Heart Failure - Category: Cardiology Authors: Tags: Original Research Article Source Type: research

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ç MT Abstract A 32-year-old male patient was admitted to the hospital with syncope. An electrocardiogram revealed complete atrioventricular (AV) block and a right bundle branch block with a QRS duration of 218 milliseconds. The heart rate was 40 beats/minute. Echocardiography revealed that both AV valves opened to a single ventricle as well as noncompaction of the myocardium. Due to New York Heart Association class III heart failure, cardiac resynchronization therapy with a defibrillator device (CRT-D) was performed. After the implantation, the electrocardiography QRS duration was reduced to 183 ms. To our ...
Source: Turk Kardiyoloji Dernegi arsivi - Category: Cardiology Authors: Tags: Turk Kardiyol Dern Ars 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
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
ConclusionsShorter time from onset of QRS to beginning of fragmentation is a simple ECG marker to predict non-responsive patients to CRT.ResumenObjetivoLa terapia de resincronización cardíaca (TRC) es una opción eficaz en el tratamiento de los pacientes con insuficiencia cardíaca y QRS ancho. Se ha demostrado que la presencia de un QRS fragmentado (QRS-f) en el electrocardiograma (ECG) de 12 derivaciones se asocia con una no respuesta a la TRC. El objetivo de este estudio es valorar si la aparición de la fragmentación (intervalo Q-f) es importante en la respuesta a la TRC.Mé...
Source: Revista Clinica Espanola - Category: Internal Medicine Source Type: research
Heart failure (HF) is a highly-prevalent progressive disease, with high mortality rate. Up to 50% of deaths are sudden, mostly from ventricular tachyarrhythmias (VT). The HF –VT relationship is reciprocal, because arrhythmias contribute to cardiomyopathy through remodeling processes. Electrophysiological (EP) abnormalities in HF involve multiple scales, from molecular modification of ion-channels and alteration of cellular calcium cycling, to structural remodeling of cardiac tissue. At the cellular scale, the changes can promote arrhythmia triggers in the form of delayed and early afterdepolarizations.
Source: Heart Rhythm - Category: Cardiology Authors: Source Type: research
Heart failure (HF) is a highly prevalent progressive disease, with a high mortality rate. Up to 50% of deaths are sudden, mostly from ventricular tachyarrhythmias (VTs). The HF –VT relationship is reciprocal because arrhythmias contribute to cardiomyopathy through remodeling processes. Electrophysiologic (EP) abnormalities in HF involve multiple scales, from molecular modification of ion channels and alteration of cellular calcium cycling, to structural remodeling of car diac tissue. At the cellular scale, the changes can promote arrhythmia triggers in the form of delayed and early afterdepolarizations.
Source: Heart Rhythm - Category: Cardiology Authors: Tags: Editorial Commentary Source Type: research
Conclusion: LV ejection fraction along with specific electrocardiographic criteria remains the cornerstone of CRT patient selection. Echocardiography is a non-invasive, cost-effective, highly reproducible method with certain limitations and accuracy that is affected by measurement errors. Echocardiography can assist with the identification of the appropriate electromechanical substrate of CRT response and LV lead placement. The targeted approach can improve the haemodynamic response, as also the patient-specific parameters estimation. PMID: 29387277 [PubMed]
Source: Open Cardiovascular Medicine Journal - Category: Cardiology Tags: Open Cardiovasc Med J Source Type: research
Abstract BACKGROUND: Myocardial fibrosis is associated with poor prognosis in nonischemic dilated cardiomyopathy (NIDCM) patients. The Selvester QRS score on 12-lead electrocardiogram is associated with both the amount of myocardial scar and poor prognosis in myocardial infarction patients. However, its use in NIDCM patients is limited. We investigated the prognostic value of the QRS score and its association with collagen volume fraction (CVF) in NIDCM patients. METHODS: We enrolled 91 consecutive NIDCM patients (66 men, 53±13 years) without permanent pacemakers or cardiac resynchronization therapy de...
Source: Journal of Cardiology - Category: Cardiology Authors: Tags: J Cardiol Source Type: research
We very much appreciate the insightful letter by Niedereret al.1 about our recent publication inEuropace.2 Most of the scientific evidence supporting the hypothetical superiority of left ventricular endocardial pacing comes from animal studies using canine models or simulation studies also based on this model.3 Unfortunately, these results have not been reproduced in clinical studies. The large multicentre prospective human trial ALternate Site Cardiac ReSYNChronization (ALSYNC), which included only patients who had failed or were unsuitable for conventional cardiac resynchronization therapy (CRT), showed that the rate of ...
Source: Europace - Category: Cardiology Source Type: research
69-year-old men with heart failure (HF) due to dilated cardiomyopathy (DCM) was referred for cardiac resynchronization therapy (CRT). He has frequent episodes of hospitalizations for acute decompensated heart failure (ADHF), requiring catecholamine-administration. He has functional class III-IV symptoms, AF with complete left bundle branch block (CLBBB) in electrocardiogram, and left ventricular ejection fraction (LVEF) of 20% in echocardiography. Considering previous history of ventricular tachycardia (VT), CRT with defibrillator (CRT-D) was implanted.
Source: Journal of Cardiac Failure - Category: Cardiology Authors: Source Type: research
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