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Noninvasive Monitoring of Stroke Volume With Resynchronization Devices in Patients With Ischemic Cardiomyopathy
Conclusions: In CRT patients with chronic infarction and wall motion abnormalities, impedance is a valid parameter to estimate stroke volume and to guide optimization of CRT timing.
Source: Journal of Cardiac Failure - August 1, 2013 Category: Cardiology Authors: Michael Kühne, Mario Bocchiardo, Herbert Nägele, Beat Schaer, Michael Lippert, Christian Sticherling, Stefan Osswald Tags: Clinical Investigations Source Type: research

Effects of Cardiac Resynchronization Therapy on Cardiac Remodeling and Contractile Function: Results From Resynchronization Reverses Remodeling in Systolic Left Ventricular Dysfunction (REVERSE) Heart Failure
Conclusion In patients with NYHA Class I/II heart failure, cardiac resynchronization therapy exerts favorable changes in left ventricular end-systolic and end-diastolic volumes and the volume intercept. The volume intercept may be useful to gain insight into prognosis in heart failure. Clinical Trial Registration URL: https://www.clinicaltrials.gov/. Unique identifier: NCT00271154.
Source: JAHA:Journal of the American Heart Association - September 11, 2015 Category: Cardiology Authors: St. John Sutton, M., Cerkvenik, J., Borlaug, B. A., Daubert, C., Gold, M. R., Ghio, S., Chirinos, J. A., Linde, C., Ky, B. Tags: Heart Failure Source Type: research

Simultaneous His Bundle and Left Ventricular Pacing for Optimal Cardiac Resynchronization Therapy Delivery: Acute Hemodynamic Assessment by Pressure-Volume Loops Original Articles
Conclusions— Standard right ventricular apex+LV and LV-only pacing enhanced systolic function and LV synchrony at individually optimized AVD close to the measured intrinsic P-H interval. By contrast, HIS+LV pacing yielded improvements, regardless of AVD setting. These findings support the hypothesis of the crucial role of intrinsic right ventricular conduction in optimal cardiac resynchronization therapy delivery.
Source: Circulation: Arrhythmia and Electrophysiology - May 8, 2016 Category: Cardiology Authors: Padeletti, L., Pieragnoli, P., Ricciardi, G., Innocenti, L., Checchi, L., Padeletti, M., Michelucci, A., Picariello, F., Valsecchi, S. Tags: Catheter Ablation and Implantable Cardioverter-Defibrillator, Congenital Heart Disease, Heart Failure, Pacemaker Original Articles Source Type: research

Atrial Fibrillation and Ventricular Arrhythmias: Sex Differences in Electrophysiology, Epidemiology, Clinical Presentation, and Clinical Outcomes.
Abstract Sex-specific differences in the epidemiology, pathophysiology, clinical presentation, clinical treatment, and clinical outcomes of atrial fibrillation (AF), sustained ventricular arrhythmias, and sudden cardiac death are recognized. Sex hormones cause differences in cardiac electrophysiological parameters between men and women that may affect the risk for arrhythmias. The incidence and prevalence of AF is lower in women than in men. However, because women live longer and AF prevalence increases with age, the absolute number of women with AF exceeds that of men. Women with AF are more symptomatic, present ...
Source: Circulation - February 6, 2017 Category: Cardiology Authors: Gillis AM Tags: Circulation Source Type: research

ESC 2017 Roundup: Biotronik touts lowered mortality for AF patients treated with cath ablation
Biotronik today released results from the Castle-AF study exploring the use of catheter ablation to treat heart failure patients with atrial fibrillation, touting a 38% composite reduction in all-cause mortality and hospitalization for worsening heart failure. The 398-patient, 33-site study compared the results of catheter ablation treatment for AF in heart failure patients using implantable cardioverter defibrillators or cardiac resynchronization therapy defibrillators to standard-of-care pharmacological therapy, the company said. Biotronik touted it as the largest study of its kind to date. Results indicated a 47% reduc...
Source: Mass Device - August 28, 2017 Category: Medical Devices Authors: Fink Densford Tags: Cardiac Assist Devices Cardiac Implants Cardiovascular Clinical Trials Biotronik Medtronic Source Type: news

Age-Dependence of Flow Homeostasis in the Left Ventricle
Conclusions: In average, blood spends 1 to 3 beats inside the LV with very low shear stress rates. The apical region is the most prone to blood stasis, particularly in mid-aged adults. The washout of blood in the normal LV is age-dependent due to physiological changes in the degree of apical penetration of the filling waves. Introduction Cardioembolic stroke is a major source of mortality and disability worldwide and blood stasis one of its major determinants (Adams et al., 1986). Left ventricular (LV) function has evolved to maximize mechanical efficiency and ensure organ perfusion at a low cost of energy and fill...
Source: Frontiers in Physiology - April 25, 2019 Category: Physiology Source Type: research

VVI Pacing with normal QRS duration and ventricular function: MOST trial findings relevant to leadless pacemakers
ConclusionIn patients without reduced LVEF or prolonged QRS duration who would be eligible for LP, DDDR and VVIR pacing demonstrated similar rates of death, stroke or heart failure hospitalization; however, VVIR pacing significantly increased the risk of AF development.This article is protected by copyright. All rights reserved
Source: Pacing and Clinical Electrophysiology : PACE - October 21, 2020 Category: Cardiology Authors: Zak Loring, Rebecca North, Anne S. Hellkamp, Brett D. Atwater, Camille G. Frazier ‐Mills, Kevin P. Jackson, Sean D. Pokorney, Gervasio A. Lamas, Jonathan P. Piccini Tags: DEVICES Source Type: research

VVI pacing with normal QRS duration and ventricular function: MOST trial findings relevant to leadless pacemakers
ConclusionIn patients without reduced LVEF or prolonged QRSd who would be eligible for LP, DDDR, and VVIR pacing demonstrated similar rates of death, stroke or HF hospitalization; however, VVIR pacing significantly increased the risk of AF development.
Source: Pacing and Clinical Electrophysiology : PACE - November 5, 2020 Category: Cardiology Authors: Zak Loring, Rebecca North, Anne S. Hellkamp, Brett D. Atwater, Camille G. Frazier ‐Mills, Kevin P. Jackson, Sean D. Pokorney, Gervasio A. Lamas, Jonathan P. Piccini Tags: DEVICES Source Type: research

HRS 2016 roundup: Leadless pacers at the fore
Medtronic (NYSE:MDT) and St. Jude Medical (NYSE:STJ), aiming to distinguish their respective leadless pacemaker offerings, presented new data last week in San Francisco at the Heart Rhythm Society’s annual meeting. St. Jude said a subset of data from the Leadless II trial showed that its Nanostim device was was successfully retrieved in 14 patients up to 3.2 years after implantation, with no serious adverse events. “We’ve now shown that for patients requiring device upgrades or new leadless pacing options, late retrievability – even up to 3 years – is possible with the Nanostim leadless pacemak...
Source: Mass Device - May 9, 2016 Category: Medical Equipment Authors: Brad Perriello Tags: Cardiovascular Clinical Trials Boston Scientific Cardiac Rhythm Management HRS 2016 Medtronic St. Jude Medical Source Type: news

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

Prediction of long-term outcome of cardiac resynchronization therapy by acute pressure-volume loop measurements
Conclusion Invasive assessment of acute haemodynamics is a reliable tool to determine individual response to CRT. An acute increase in SW predicts long-term response to CRT with a higher accuracy than an acute increase in dP/dtmax, baseline QRS duration, and degree of LV mechanical dyssynchrony.
Source: European Journal of Heart Failure - February 20, 2013 Category: Cardiology Authors: de Roest, G. J., Allaart, C. P., Kleijn, S. A., Delnoy, P. P. H. M., Wu, L., Hendriks, M. L., Bronzwaer, J. G. F., van Rossum, A. C., de Cock, C. C. Tags: CRT Source Type: research

Effect of atrioventricular and ventriculoventricular delay optimization on clinical and echocardiographic outcomes of patients treated with cardiac resynchronization therapy: A meta-analysis
Conclusion: The current literature suggests that routine AV and/or VV delay optimization has a neutral effect on clinical and echocardiographic outcomes based on pooled data from randomized and nonrandomized studies. Standardization of patient selection and optimization timing and method may help to further define the role of CRT device optimization.
Source: American Heart Journal - May 2, 2013 Category: Cardiology Authors: Dominique Auger, Ulas Hoke, Jeroen J. Bax, Eric Boersma, Victoria Delgado Tags: Curriculum in 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

Scar tissue–guided left ventricular lead placement for cardiac resynchronization therapy in patients with ischemic cardiomyopathy: An acute pressure-volume loop study
Background: Response to cardiac resynchronization therapy (CRT) is hampered by the extent and location of left ventricular (LV) scar tissue. It is commonly advised to avoid scar tissue while placing the LV lead. However, whether individual patients benefit from this strategy remains unclear.Methods: Thirty-two CRT candidates with ischemic cardiomyopathy were enrolled from 2 successive clinical trials (TBS and E-pot study). Magnetic resonance imaging with late contrast enhancement was performed to assess location, degree and transmurality of LV scar tissue. Patients underwent invasive pressure-volume loop measurements to as...
Source: American Heart Journal - January 16, 2014 Category: Cardiology Authors: Gerben Jan de Roest, LiNa Wu, Carel C. de Cock, Matthijs L. Hendriks, Peter Paul H.M. Delnoy, Albert C. van Rossum, Cornelis P. Allaart Tags: Heart Failure Source Type: research

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