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https://www.readbyqxmd.com/read/28494974/multiple-comorbidities-and-response-to-cardiac-resynchronization-therapy-madit-crt-long-term-follow-up
#1
Emily P Zeitler, Daniel J Friedman, James P Daubert, Sana M Al-Khatib, Scott D Solomon, Yitschak Biton, Scott McNitt, Wojciech Zareba, Arthur J Moss, Valentina Kutyifa
BACKGROUND: Data regarding cardiac resynchronization therapy (CRT) in patients with multiple comorbidities are limited. OBJECTIVES: This study evaluated the association of multiple comorbidities with the benefits of CRT over implantable cardioverter-defibrillator (ICD) alone. METHODS: We examined 1,214 MADIT-CRT (Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy) study patients with left bundle branch block (LBBB) and 0, 1, 2, or ≥3 comorbidities, including renal dysfunction, hypertension (HTN), diabetes, coronary artery disease, history of atrial arrhythmias, history of ventricular arrhythmias, current smoking, and cerebrovascular accident...
May 16, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28467647/prediction-of-optimal-cardiac-resynchronization-by-vectors-extracted-from-electrograms-in-dyssynchronous-canine-hearts
#2
Elien B Engels, Marc Strik, Lars B van Middendorp, Marion Kuiper, Kevin Vernooy, Frits W Prinzen
INTRODUCTION: Proper optimization of atrioventricular (AV) and interventricular (VV) intervals can improve the response to cardiac resynchronization therapy (CRT). It has been demonstrated that the area of the QRS complex (QRSarea) extracted from the vectorcardiogram can be used as a predictor of optimal CRT-device settings. We explored the possibility of extracting vectors from the electrograms (EGMs) obtained from pacing electrodes and of using these EGM-based vectors (EGMVs) to individually optimize acute haemodynamic CRT response...
May 3, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28444180/left-bundle-branch-block-from-cardiac-mechanics-to-clinical-and-diagnostic-challenges
#3
Elena Surkova, Luigi P Badano, Roberto Bellu, Patrizia Aruta, Federica Sambugaro, Gabriella Romeo, Federico Migliore, Denisa Muraru
Left bundle branch block (LBBB) results in an altered pattern of left ventricular (LV) activation and subsequent contraction, causing remarkable changes in LV mechanics, perfusion and workload and ultimately leading to pathologic cardiac remodelling. Clinical and diagnostic notions about the LBBB phenomenon had evolved from just an electrocardiographic pattern to a critically important finding affecting diagnostic and clinical management of many patients and adversely influencing their outcomes. Recent advances in imaging techniques significantly improved the assessment of patients with LBBB and provided additional insights into pathophysiological mechanisms of LV remodelling...
April 20, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28439482/association-of-non-alcoholic-fatty-liver-disease-with-conduction-defects-on-electrocardiogram
#4
Muhammad A Mangi, Abdul M Minhas, Hiba Rehman, Furquan Pathan, Hong Liang, Sary Beidas
BACKGROUND: Non-alcoholic fatty liver disease (NAFLD) is a leading cause of liver disease in developed countries. The association of NAFLD with conduction defects is unknown. The aim of our study was to find whether an association exists between conduction defects and NAFLD. METHODS: This is a case-control retrospective study of 700 patients admitted to Orange Park Medical Center, Orange Park, Florida from 2009 to 2015. Patients with a history of alcohol use, congenital heart disease, infiltrative malignancy, and myocarditis were excluded from the study...
March 21, 2017: Curēus
https://www.readbyqxmd.com/read/28427578/implantable-cardioverter-defibrillators-with-versus-without-resynchronization-therapy-in-patients-with-a-qrs-duration%C3%A2-180-ms
#5
Varun Sundaram, Jayakumar Sahadevan, Albert L Waldo, George J Stukenborg, Yogesh N V Reddy, Samuel J Asirvatham, Judith A Mackall, Anselma Intini, Brigid Wilson, Daniel I Simon, Kenneth C Bilchick
BACKGROUND: More than 20% of Medicare beneficiaries receiving cardiac resynchronization therapy defibrillators (CRT-D) have a very wide (≥180 ms) QRS complex duration (QRSD). Outcomes of CRT-D in these patients are not well-established because they have been underrepresented in clinical trials. OBJECTIVES: This study examined outcomes in patients with CRT-D in a very wide QRSD with left bundle branch block (LBBB) versus those without LBBB. METHODS: Medicare patients from the Implantable Cardioverter Defibrillator Registry (January 1, 2005, through April 30, 2006) with a CRT-D and confirmed Class I or IIa indications for CRT-D were matched to implantable cardioverter-defibrillator (ICD) patients without CRT despite having Class I or IIa indications for CRT...
April 25, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28416358/non-gated-high-pitch-computed-tomography-aortic-angiography-myocardial-perfusion-defects-in-patients-with-suspected-aortic-dissection
#6
Li-Ting Huang, Shih-Hung Chan, Chia-Chang Chuang, Yi-Shan Tsai
OBJECTIVES: To investigate the diagnostic value of first-pass myocardial perfusion defects visualised in non-gated high-pitch computed tomography angiography (CTA) in patients admitted to the emergency department (ED) for suspected aortic dissection. METHODS: We recruited 174 ED patients who underwent high-pitch CTA of the aorta because of suspected aortic dissection. We divided these patients into two groups (diseased and control groups) based on whether their clinical data fulfilled the third universal definition of acute myocardial infarction (AMI), specifically an increase in cardiac troponin (cTn) with at least one of the following: (a) symptoms of ischemia; (b) new ST-segment-T wave (ST-T) changes or new left bundle branch block (LBBB); (c) development of pathological Q wave; (d) new loss of viable myocardium or new regional wall motion abnormality; or (e) identification of an intracoronary thrombus by angiography or autopsy...
April 12, 2017: Journal of Cardiovascular Computed Tomography
https://www.readbyqxmd.com/read/28416247/adaptive-crt-in-patients-with-normal-av-conduction-and-left-bundle-branch-block-does-qrs-duration-matter
#7
Hiro Yamasaki, Daniel Lustgarten, Jeffrey Cerkvenik, David Birnie, Maurizio Gasparini, Kathy Lia-Fun Lee, Yukio Sekiguchi, Niraj Varma, Bernd Lemke, Randall C Starling, Kazutaka Aonuma
BACKGROUND: Adaptive cardiac resynchronization therapy (aCRT) is a dynamic optimization algorithm which paces only the left ventricle (LV) when atrio-ventricular (AV) conduction is normal, thus reducing right ventricular (RV) pacing. However, the impact of QRS duration on aCRT efficacy remains uncertain. We examined whether QRS duration impacts aCRT effectiveness in patients with left bundle branch block (LBBB) and preserved AV conduction. METHODS: Randomized patients in the Adaptive CRT trial, which enrolled NYHA III/IV patients, were used in this analysis...
April 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28398490/the-prognostic-benefit-of-cardiac-resynchronization-therapy-is-greater-in-concordant-vs-discordant-left-bundle-branch-block-in-the-multicenter-automatic-defibrillator-implantation-trial-cardiac-resynchronization-therapy-madit-crt
#8
Luigi Padeletti, Alberto Aimo, Bella Vishenvsky, Arielle Schwartz, Scott McNitt, Paul J Wang, Arthur J Moss, Michele Emdin, Wojciech Zareba
Aims: Discordant and concordant left bundle branch block (dLBBB/cLBBB) are characterized by negative or positive T waves, respectively, in lateral leads. We assessed if the two morphologies are associated with different clinical status and prognosis in patients with heart failure (HF) and current indication to Cardiac Resynchronization Therapy (CRT)/CRT-Defibrillator (CRT-D). Methods and results: Baseline electrocardiograms of 1270 patients with LBBB in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy cohort were analysed to identify dLBBB and cLBBB...
April 7, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28391991/relation-of-qrs-duration-to-response-to-cardiac-resynchronization-therapy-in-patients-with-left-bundle-branch-block
#9
Biagio Sassone, Matteo Bertini, Matteo Beltrami, Michele Malagù, Giovanni Pasanisi, Helene Afi Kuwornu, Nicola Avigni, Giuseppe Fucà, Federico Pacchioni, Monica Minarelli, Maria Letizia Bacchi Reggiani, Luigi Padeletti
Left ventricular (LV) dyssynchrony (LVdys) is a necessary condition for successful cardiac resynchronization therapy (CRT). Despite left bundle branch block (LBBB) representing a reliable surrogate of LVdys, not all LBBB patients will respond to CRT. Our aim was to investigate the relation between QRS duration and LVdys in patients with LBBB who underwent CRT. We retrospectively studied 165 patients with LBBB who underwent CRT implantation according to the current guidelines. A 6-month reduction of LV end-systolic volume ≥15% identified responders to CRT...
June 1, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28387465/qt-interval-correction-in-lbbb-improving-the-accuracy-of-an-imperfect-measurement
#10
EDITORIAL
Basil Abu-El-Haija, J Paul Mounsey
No abstract text is available yet for this article.
April 7, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28382083/prognostic-implication-of-the-qrs-axis-and-its-association-with-myocardial-scarring-in-patients-with-left-bundle-branch-block
#11
Chan Soon Park, Myung-Jin Cha, Eue-Keun Choi, Seil Oh
BACKGROUND AND OBJECTIVES: Left bundle branch block (LBBB) with left axis deviation (LAD) has a worse prognosis than LBBB with a normal axis, and myocardial dysfunction has been suggested as a cause of left axis deviation. This study investigated the prognostic significance of the QRS axis in patients with LBBB and analyzed its relationship with the amount of myocardial scarring. SUBJECTS AND METHODS: A total of 829 patients were diagnosed with LBBB at Seoul National University Hospital from October 2004 to June 2014...
March 2017: Korean Circulation Journal
https://www.readbyqxmd.com/read/28344217/left-ventricular-twist-was-decreased-in-isolated-left-bundle-branch-block-with-preserved-ejection-fraction
#12
Sabiye Yılmaz, Harun Kılıc, Mustafa Tarık Ağac, Nurgül Keser, Efe Edem, Saadet Demirtaş, Mehmet Bülent Vatan, Ramazan Akdemir, Hüseyin Gündüz
OBJECTIVE: Left ventricular (LV) rotation and twist play an important role in LV contraction and relaxation. Left bundle branch block (LBBB) deteriorates both diastolic and systolic functions. We evaluated the LV twist in patients with LBBB and preserved ejection fraction (EF) (>50%) to determine twist as a potential marker for subtle myocardial dysfunction. METHODS: This observational cross-sectional study included 34 LBBB patients with preserved EF who were free from ischemic and valvular disease (Group 1) and 36 healthy controls (Group 2)...
March 22, 2017: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/28340150/severe-conduction-defects-requiring-permanent-pacemaker-implantation-in-patients-with-a-new-onset-left-bundle-branch-block-after-transcatheter-aortic-valve-implantation
#13
V J Nijenhuis, V F Van Dijk, S M Chaldoupi, J C Balt, J M Ten Berg
Aims: Transcatheter aortic valve implantation (TAVI) is frequently associated with cardiac conduction defects (CCD) requiring permanent pacemaker implantation (PPI). Although new-onset left bundle branch block (LBBB) is often seen, the rate of progression to severe CCD is unclear. We aimed to find clinical and electrocardiographic (ECG) parameters associated with severe CCD requiring PPI in patients with a new-onset LBBB after TAVI and assess its effect on clinical outcome. Methods and results: All consecutive patients undergoing TAVI who developed a new-onset LBBB were retrospectively analysed...
March 17, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28318665/the-relation-between-local-repolarization-and-t-wave-morphology-in-heart-failure-patients
#14
Francesco Maffessanti, Joris Wanten, Mark Potse, Francois Regoli, Maria Luce Caputo, Giulio Conte, Daniel Sürder, Annekatrin Illner, Rolf Krause, Tiziano Moccetti, Angelo Auricchio, Frits W Prinzen
BACKGROUND: Both duration and morphology of the T-wave are regarded important parameters describing repolarization of the ventricles. Conventionally, T-wave concordance is explained by an inverse relation between the time of depolarization (TD) and repolarization (TR). Little is known about T-wave morphology and TD-TR relations in patients with heart failure. METHODS: Electro-anatomic maps were obtained in the left (LV) and right ventricle (RV) and in the coronary sinus (CS) in patients with heart failure with narrow (nQRS, n=8) and wide QRS complex with (LBBB, n=15) and without left bundle branch block (non-LBBB, n=7)...
February 22, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28297125/a-new-formula-for-estimating-the-true-qt-interval-in-left-bundle-branch-block
#15
Binhao Wang, L I Zhang, Peixin Cong, Huimin Chu, Ying Liu, Jinqiu Liu, William Surkis, Yunlong Xia
INTRODUCTION: QT prolongation is an independent risk factor for cardiac mortality. Left bundle branch block (LBBB) is more common in patients as they age. Widening of the QRS in LBBB causes false QT prolongation and thus makes true QT assessment difficult. We aimed to develop a simple formula to achieve a good estimate of the QT interval in the presence of LBBB. METHODS AND RESULTS: To determine the effect of QRS duration on the QT interval, QRS and QT were measured in sinus rhythm and during right ventricular apical pacing in 62 patients (age 55 ± 11 years, 60% male) undergoing electrophysiology studies...
March 15, 2017: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/28294356/prevalence-and-clinical-significance-of-left-bundle-branch-block-according-to-classical-or-strict-definition-criteria-in-permanent-pacemaker-patients
#16
Andrea Mazza, Maria Grazia Bendini, Raffaele De Cristofaro, Mariolina Lovecchio, Sergio Valsecchi, Massimo Leggio, Giuseppe Boriani
BACKGROUND: Previous studies have shown that the presence of left bundle branch block (LBBB) is associated with an increased risk of cardiac mortality and heart failure (HF). Recently, new criteria to define strict LBBB have been proposed: QRS duration ≥140 ms for men and ≥130 ms for women, along with mid-QRS notching or slurring in ≥2 contiguous leads. HYPOTHESIS: We assessed the prevalence and prognostic significance of LBBB according to classical (QRS duration ≥120ms) and strict criteria in permanent pacemaker patients...
March 10, 2017: Clinical Cardiology
https://www.readbyqxmd.com/read/28290858/-left-bundle-branch-block-in-unstable-angina-mortality-and-rate-of-myocardial-infarction
#17
V M Baev, E V Lantsova, D B Kozlov, E F Varova
AIM: to study mortality and adverse outcomes in patients with unstable angina (UA) and left bundle branch block (LBBB). MATERIAL AND METHODS: We included in this study UA patients with (n=56) and without LBBB (n=310). Period of observation was 14 days (from admission to discharge). The following events were considered as adverse outcomes: death, myocardial infarction, carcinogenic shock, and stroke. RESULTS: Combination of UA with LBBB was associated with increases of risk of death (3...
September 2016: Kardiologiia
https://www.readbyqxmd.com/read/28258679/-predictive-parameters-of-occurrence-of-adequate-interventions-in-patients-with-implanted-cardioverter-defibrillators-with-or-without-resynchronisation-therapy-in-primary-prevention-of-sudden-cardiac-death-in-dilated-cardiomyopathy
#18
Jacek Lelakowski, Anna Rydlewska, Maria Lelakowska, Joanna Pudło, Justyna Piekarz
The task of the ICD is to detect ventricular arrhythmias and treatment of its adequate intervention. The task of the CRTD in addition to the above tasks is the treatment of heart failure. AIM: The aim of the study was to assess the predictive parameters of adequate interventions in patients with an ICD and CRTD. MATERIALS AND METHODS: The study consisted of 273 patients (230 M, mean age 65±11 years) with ICD and/or CRTD. The inclusion criteria were: left ventricle ejection fraction (LVEF) ≤ 35%, NYHA class ≥ II, implantation in primary SCD prevention and in case of CRTD additionally LBBB with wide QRS ≥ 120ms...
February 20, 2017: Polski Merkuriusz Lekarski: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28248410/low-permanent-pacemaker-rates-following-lotus-device-implantation-for-transcatheter-aortic-valve-replacement-due-to-modified-implantation-protocol
#19
Florian Krackhardt, Behrouz Kherad, Maximilian Krisper, Burkert Pieske, Michael Laule, Carsten Tschöpe
BACKGROUND: Conduction disturbances requiring permanent pacemaker implantation following transcatheter aortic valve replacement (TAVR) are a common problem. Pacemaker implantation rates after TAVR appear to be higher compared to conventional aortic valve replacement. The aim of this study was to analyze whether a high annulus implantation conveys the benefit of a decreased rate of permanent pacemaker implantation while being safe and successful according to VAR2-criteria. METHODS: A total of 23 patients with symptomatic severe aortic valve stenosis, an aortic annulus of 19-27mm and at high risk for surgery were treated with the Lotus valve...
March 1, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28248005/evaluation-of-the-ecg-based-selvester-scoring-method-to-estimate-myocardial-scar-burden-and-predict-clinical-outcome-in-patients-with-left-bundle-branch-block-with-comparison-to-late-gadolinium-enhancement-cmr-imaging
#20
Uzma Chaudhry, Pyotr G Platonov, Robert Jablonowski, Jean-Philippe Couderc, Henrik Engblom, Xiajuang Xia, Björn Wieslander, Brett D Atwater, David G Strauss, Jesper Van der Pals, Martin Ugander, Marcus Carlsson, Rasmus Borgquist
BACKGROUND: Myocardial scar burden quantification is an emerging clinical parameter for risk stratification of sudden cardiac death and prediction of ventricular arrhythmias in patients with left ventricular dysfunction. We investigated the relationships among semiautomated Selvester score burden and late gadolinium enhancement-cardiovascular magnetic resonance (LGE-CMR) assessed scar burden and clinical outcome in patients with underlying heart failure, left bundle branch block (LBBB) and implantable cardioverter-defibrillator (ICD) treatment...
March 1, 2017: Annals of Noninvasive Electrocardiology
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