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Cardiac Responses to Left Ventricular Pacing in Hearts with Normal Electrical Conduction: Beneficial Effect of Improved Filling is Counteracted by Dyssynchrony.
In conclusion, pacing of the LV lateral wall increased LVEDV by displacing the septum rightwards, suggesting a mechanism for a favorable effect of CRT in narrow QRS. The pacing, however, induced dyssynchrony and therefore reduced LV systolic function. These observations suggest that detrimental effects should be considered when applying CRT in patients with narrow QRS. PMID: 24906920 [PubMed - as supplied by publisher]
Source: American Journal of Physiology. Heart and Circulatory Physiology - June 6, 2014 Category: Physiology Authors: Boe E, Russell K, Remme EW, Gjesdal O, Smiseth OA, Skulstad H Tags: Am J Physiol Heart Circ Physiol Source Type: research

Complex cardiac pacing in the setting of a district general hospital: procedural success and complications
Conclusions In the presence of necessary clinical expertise, complex cardiac devices can be implanted successfully and with a high degree of safety in the setting of a district general hospital.
Source: Heart Asia - June 24, 2014 Category: Cardiology Authors: Rahbi, H., El-din, M., Salloum, M., Shaukat, N., Farooq, M. Tags: Original research Source Type: research

Cardiac responses to left ventricular pacing in hearts with normal electrical conduction: beneficial effect of improved filling is counteracted by dyssynchrony
In conclusion, pacing of the LV lateral wall increased LVEDV by displacing the septum rightward, suggesting a mechanism for a favorable effect of CRT in narrow QRS. The pacing, however, induced dyssynchrony and therefore reduced LV systolic function. These observations suggest that detrimental effects should be considered when applying CRT in patients with narrow QRS.
Source: AJP: Heart and Circulatory Physiology - August 1, 2014 Category: Cardiology Authors: Boe, E., Russell, K., Remme, E. W., Gjesdal, O., Smiseth, O. A., Skulstad, H. Tags: MUSCLE MECHANICS AND VENTRICULAR FUNCTION Source Type: research

Cardiac Resynchronization Therapy Acutely Improves Ventricular‐Arterial Coupling by Reducing the Arterial Load: Assessment by Pressure–Volume Loops
ConclusionOur data indicate that switching CRT on induces an immediate reduction in arterial load, conceivably as a consequence of restored autonomic balance.
Source: Pacing and Clinical Electrophysiology : PACE - January 28, 2015 Category: Cardiology Authors: PAOLO PIERAGNOLI, GIOVANNI BATTISTA PEREGO, GIUSEPPE RICCIARDI, STEFANIA SACCHI, MARGHERITA PADELETTI, ANTONIO MICHELUCCI, SERGIO VALSECCHI, LUIGI PADELETTI Tags: ORIGINAL ARTICLE Source Type: research

Echocardiography and cardiac resynchronization therapy
Publication date: Available online 12 September 2015 Source:Cor et Vasa Author(s): Josef Marek, Jana Gandalovičová, Eva Kejřová, Miroslav Pšenička, Aleš Linhart, Tomáš Paleček Cardiac resynchronization therapy (CRT) is an effective therapeutic option in patients with congestive heart failure, left ventricular ejection fraction≤35%, and a widened QRS complex. However, a significant proportion of individuals do not respond to CRT favorably. Understandably, a large number of studies have addressed various techniques to improve patient selection for CRT and to improve responder rate in patients with CRT dev...
Source: Cor et Vasa - September 12, 2015 Category: Cardiology Source Type: research

Mortality After Atrioventricular Nodal Radiofrequency Catheter Ablation With Permanent Ventricular Pacing in Atrial Fibrillation: Outcomes From a Controlled Nonrandomized Study Original Article
Conclusions— In sick AF patients with multiple comorbidities, AVNA with permanent ventricular pacing for rate control seems safe during follow-up and may be associated with lower mortality.
Source: Circulation: Arrhythmia and Electrophysiology - June 29, 2016 Category: Cardiology Authors: Garcia, B., Clementy, N., Benhenda, N., Pierre, B., Babuty, D., Olshansky, B., Fauchier, L. Tags: Catheter Ablation and Implantable Cardioverter-Defibrillator, Atrial Fibrillation Original Article Source Type: research

Atrioventricular dyssynchrony from empiric device settings is common in cardiac resynchronization therapy and adversely impacts left ventricular morphology and function
ConclusionOur study suggests that up to 50% of patients with empiric device settings have AV dyssynchrony at 6 months despite atrioventricular delay optimization (AVO) algorithms. As AV dyssynchrony is common and has proven to be modifiable, a strategic approach to Doppler echocardiography‐guided AVO after CRT is warranted, particularly in nonresponders where the LV filling pattern is fused or truncated.
Source: Echocardiography - February 28, 2017 Category: Cardiology Authors: Gregory J. Sinner, Vedant A. Gupta, Arash Seratnahaei, Richard J. Charnigo, Yousef H. Darrat, Samy C. Elayi, Steve W. Leung, Vincent L. Sorrell Tags: ORIGINAL INVESTIGATION Source Type: research

Heart rate and dyssynchrony in patients with cardiac resynchronization therapy: a pilot study.
The objective of this pilot study was to describe the impact of paced heart rate on left ventricular (LV) mechanical dyssynchrony in synchronous compared to dyssynchronous pacing modes in patients with heart failure. METHODS: Echocardiography was performed in 14 cardiac resynchronization therapy (CRT) patients at paced heart rates of 70 and 90 bpm in synchronous- (CRT), and dyssynchronous (atrial pacing + wide QRS activation) pacing modes. LV dyssynchrony was quantified using the 12-segment standard deviation model (Ts-SD) derived from Tissue Doppler Imaging. In addition, cardiac cycle intervals were assessed using...
Source: Scandinavian Cardiovascular Journal - March 27, 2017 Category: Cardiology Tags: Scand Cardiovasc J Source Type: research

Heart failure study of multipoint pacing effects on ventriculoarterial coupling: Rationale and design of the HUMVEE trial
Cardiac resynchronization therapy (CRT) is an established therapy for symptomatic heart failure (HF). Unfortunately, many recipients remain nonresponders. Studies have revealed the potential role of multipoint pacing (MPP) in improving response and outcomes. The aim of this study is to compare the effects of MPP against those of standard biventricular pacing (BVP) on (i) ventriculoarterial coupling (VAC) and energy efficiency of the failing heart, (ii) diastolic function, (iii) quality of life, and (iv) NT‐proBNP levels and glomerular filtration rate (GFR) during a follow‐up of 13 months. HUMVEE is a single‐center, ...
Source: Annals of Noninvasive Electrocardiology - October 15, 2017 Category: Cardiology Authors: Christina Chrysohoou, Polychronis Dilaveris, Christos ‐Konstantinos Antoniou, Ioannis Skiadas, Konstantinos Konstantinou, Konstantinos Gatzoulis, Ioannis Kallikazaros, Dimitrios Tousoulis Tags: ORIGINAL ARTICLE Source Type: research

Recent advances in heart failure
Purpose of review Acute heart failure continues to be a challenge as there is limited benefit of numerous agents that have been tested. Cardiac resynchronization therapy remains standard of care, yet timing and need for implantable cardiac defibrillator has been brought into question with the recent randomized trials. Several recent advances have been made towards management of heart failure both in drug and device therapy. The purpose of this review is to provide an update on the most important recent studies on heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpE...
Source: Current Opinion in Cardiology - February 8, 2018 Category: Cardiology Tags: Special Commentaries Source Type: research

EBR Systems launches trial for wireless pacer
EBR Systems said yesterday that it launched a 350-patient investigational device exemption trial of its Wise wireless pacemaker it hopes to use to win FDA approval. Sunnyvale, Calif.-based EBR’s device uses a subcutaneous generator to wirelessly deliver ultrasound energy to a “pellet” implanted in the right ventricle, which it uses to synchronize the left and right ventricles. The system is designed to eliminate the need for a left ventricular lead by allowing the operating physician to place the stimulation “pellet” in a patient-specific location inside the left ventricle. The FDA approved the Solve-CRT stu...
Source: Mass Device - March 8, 2018 Category: Medical Devices Authors: Brad Perriello Tags: Cardiovascular Clinical Trials Cardiac Rhythm Management EBR Systems Inc. Source Type: news

Can We Use the Intrinsic Left Ventricular Delay (QLV) to Optimize the Pacing Configuration for Cardiac Resynchronization Therapy With a Quadripolar Left Ventricular Lead? Original Articles
Conclusions: The large variation in acute hemodynamic response indicates that the choice of the stimulated electrode on a quadripolar lead is important. Although QLV/QRSd was associated with acute hemodynamic response at group level, it cannot be used to select the optimal electrode in the individual patient.
Source: Circulation: Arrhythmia and Electrophysiology - March 16, 2018 Category: Cardiology Authors: van Everdingen, W. M., Zweerink, A., Cramer, M. J., Doevendans, P. A., Nguyen, U. C., van Rossum, A. C., Prinzen, F. W., Vernooy, K., Allaart, C. P., Meine, M. Tags: Heart Failure, Pacemaker Original Articles Source Type: research

Medtronic touts reduced AF, improved activity in AdaptivCRT studies
Medtronic (NYSE:MDT) today released results from two real-world analyses of its AdaptivCRT algorithm, touting that its use was linked to a reduction in atrial fibrillation episodes and higher patient activity levels. Results from the analyses, which involved a total of 408 patients at 26 centers in Italy, were presented at the European Heart Rhythm Association’s Scientific Sessions 2018 in Barcelona, Spain, the company said. Medtronic’s AdaptivCRT algorithm is designed to adjust pacing to the heart dependent upon evaluations of heart rhythm made every minute, the company said. The program has been shown to in...
Source: Mass Device - March 20, 2018 Category: Medical Devices Authors: Fink Densford Tags: Cardiac Assist Devices Cardiac Implants Cardiovascular Clinical Trials Software / IT Medtronic Source Type: news

Incidence, Clinical Characteristics, and Long-term Outcome of the Dilated Phase of Hypertrophic Cardiomyopathy.
Abstract Some patients with hypertrophic cardiomyopathy (HCM) develop systolic dysfunction, called the dilated phase of HCM (d-HCM), which is associated with increased morbidity and mortality. We conducted a retrospective study using an HCM database to clarify the incidence, clinical characteristics, and long-term outcomes of d-HCM. We analyzed an HCM cohort consisting of 434 patients (273 with apical HCM and 161 with non-apical HCM; 18 had obstructive HCM, 16 had dilated HCM, and 127 had other HCM) diagnosed by echocardiography in our hospital between 1991 and 2010. The follow-up period was 8.4 ± 6.7 years. The ...
Source: The Keio Journal of Medicine - December 29, 2018 Category: Universities & Medical Training Authors: Aizawa Y, Tanimoto Y, Hirata Y, Fujisawa T, Fukuoka R, Nakajima K, Katsumata Y, Nishiyama T, Kimura T, Yuasa S, Kohno T, Kohsaka S, Murata M, Maekawa Y, Furukawa Y, Takatsuki S, Fukuda K Tags: Keio J Med Source Type: research

Temporal Trends of Cardiac Implantable Electronic Device Implantations: a Nationwide Population-based Study.
CONCLUSIONS: The number of CIED implantation increased substantially from 2009 to 2016 in Korea. Also, the patients with CIED have been changed to be older and have more comorbidities. Therefore, the burden of health care cost in patients with CIED would be expected to increase in the future. PMID: 31074230 [PubMed - as supplied by publisher]
Source: Korean Circulation Journal - May 12, 2019 Category: Cardiology Tags: Korean Circ J Source Type: research

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