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New insights from a computational model on the relation between pacing site and CRT response
Conclusions</div>In these model simulations, the best cardiac function was obtained when pacing the mid-basal LV lateral wall, because of fastest recruitment of LV activation. This study illustrates how computer modeling can shed new light on optimizing pacing therapies for CRT. The results from this study may help to design new clinical studies to further investigate the importance of the pacing site for CRT response.</span>
Source: Europace - December 22, 2016 Category: Cardiology Source Type: research

Endocardial left ventricular pacing for cardiac resynchronization: systematic review and meta-analysis
ConclusionLV endocardial pacing appears to be a viable technique when conventional lead placement is not possible. Response rates were heterogeneous but comparable with conventional CRT. There is likely to be a small increase over expected rates of stroke, although included patients were high risk.
Source: Europace - January 10, 2017 Category: Cardiology Source Type: research

CHADS2 and CHA2DS2-VASc scores to predict morbidity and mortality in heart failure patients candidates to cardiac resynchronization therapy
Conclusion In CRT-D patients, pre-implant CHA2DS2-VASc score is an independent predictor of major clinical events at 30-month follow-up.
Source: Europace - December 16, 2013 Category: Cardiology Authors: Paoletti Perini, A., Bartolini, S., Pieragnoli, P., Ricciardi, G., Perrotta, L., Valleggi, A., Vergaro, G., Michelotti, F., Boggian, G., Sassone, B., Mascioli, G., Emdin, M., Padeletti, L. Tags: Pacing and resynchronization therapy Source Type: research

Bifocal left ventricular stimulation or the optimal left ventricular stimulation site in cardiac resynchronization therapy: a pressure-volume loop study
Conclusion Stimulation at the optimal LV site showed a significantly higher pump function improvement compared with bifocal LV stimulation. Mechanical activation at the optimal LV site was significantly more delayed compared with the non-optimal LV site. In general, these results suggest that implantation of a second LV lead yields no additional benefit over implantation of one optimally placed LV lead. However, a bifocal approach might be beneficial in the individual patient.
Source: Europace - June 28, 2016 Category: Cardiology Authors: de Roest, G. J., Wu, L., de Cock, C. C., Delnoy, P.-P. H. M., Hendriks, M. L., van Rossum, A. C., Allaart, C. P. Tags: Pacing and resynchronization therapy Source Type: research

Improved patient selection for cardiac resynchronization therapy by normalization of QRS duration to left ventricular dimension
ConclusionSince normalized QRSd reflects myocardial conduction properties, these findings suggest that myocardial conduction velocity rather than increased path length mainly determines response to CRT. Normalizing QRSd to LV dimension might provide a relatively simple method to improve patient selection for CRT.
Source: Europace - October 5, 2016 Category: Cardiology Source Type: research

Frailty syndrome: an emerging clinical problem in the everyday management of clinical arrhythmias. The results of the European Heart Rhythm Association survey
In conclusion, the complex clinical condition in frail patients presenting with arrhythmias warrants an integrated multidisciplinary approach both for the management of rhythm disturbances and for the decision on using CIEDs.
Source: Europace - October 10, 2017 Category: Cardiology Source Type: research