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https://www.readbyqxmd.com/read/27890282/selective-versus-non-selective-his-bundle-pacing-for-cardiac-resynchronization-therapy
#1
REVIEW
Gaurav A Upadhyay, Roderick Tung
Cardiac resynchronization therapy (CRT) has an established role in the device-based therapy for patients with systolic dysfunction and intraventricular conduction delay, particularly left bundle branch block (LBBB). Recently, His bundle pacing (HBP) has emerged as a viable alternative for resynchronization which can successfully narrow surface QRS and improve mechanical dyssynchrony. The role of selective (i.e., an isoelectric His-paced to QRS interval similar to native HV interval) versus non-selective capture (i...
October 18, 2016: Journal of Electrocardiology
https://www.readbyqxmd.com/read/27886918/cardiac-resynchronization-therapy-an-overview-on-guidelines
#2
REVIEW
Giuseppe Boriani, Martina Nesti, Matteo Ziacchi, Luigi Padeletti
Cardiac resynchronization therapy (CRT) is included in international consensus guidelines as a treatment with proven efficacy in well-selected patients on top of optimal medical therapy. Although all the guidelines strongly recommend CRT for LBBB with QRS duration greater than 150 milliseconds, lower strength of recommendation is reported for QRS duration of 120 to 150 milliseconds, especially if not associated with LBBB. CRT is not recommended for a QRS of less than 120 milliseconds. No indication emerges for guiding the implant based on echocardiographic evaluation of dyssynchrony...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27885752/biventricular-paced-qrs-area-predicts-acute-hemodynamic-crt-response-better-than-qrs-duration-or-qrs-amplitudes
#3
Jan DE Pooter, Milad El Haddad, Marc DE Buyzere, Hernandez Alfonso Aranda, Richard Cornelussen, Berthold Stegemann, Christopher A Rinaldi, Maciej Sterlinski, Adam Sokal, Darrel P Francis, Luc Jordaens, Roland X Stroobandt, Frederic VAN Heuverswyn, Frank Timmermans
INTRODUCTION: Vectorcardiographic (VCG) QRS area of left bundle branch block (LBBB) predicts acute hemodynamic response in cardiac resynchronization therapy (CRT) patients. We hypothesized that changes in QRS area occurring with biventricular pacing (BV) might predict acute hemodynamic CRT response (AHR). METHODS AND RESULTS: VCGs of 624 BV paced electrocardiograms (25 LBBB patients with 35 different pacing configurations) were calculated according to Frank's orthogonal lead system...
November 25, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27885751/effect-of-pr-interval-on-outcomes-following-cardiac-resynchronization-therapy-a-secondary-analysis-of-the-companion-trial
#4
Jeffrey Lin, Kevin A Buhr, Ryan Kipp
BACKGROUND: Prolonged PR intervals may impair atrioventricular mechanical coupling and adversely affect cardiac performance. We hypothesize that patients with advanced systolic heart failure, wide QRS complexes, and prolonged PR intervals will have improved survival from CRT-D regardless of whether LBBB or non-LBBB is present. METHODS AND RESULTS: A total of 308 patients enrolled in the OPT and and 595 patients in the CRT-D arms of the COMPANION trial were stratified according to normal (≤230 ms) or prolonged PR interval (>230 ms)...
November 25, 2016: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/27867072/changes-in-electrical-dyssynchrony-by-body-surface-mapping-predict-left-ventricular-remodeling-in-cardiac-resynchronization-therapy-patients
#5
Ryan M Gage, Antonia E Curtin, Kevin V Burns, Subham Ghosh, Jeffrey M Gillberg, Alan J Bank
BACKGROUND: Electrical activation is important in CRT response. Standard ECG analysis may not accurately reflect the heterogeneity of electrical activation. OBJECTIVE: We compared changes in LV size and function following CRT to native electrical dyssynchrony and its change during pacing. METHODS: Body-surface isochronal maps utilizing 53 anterior and posterior electrodes, and 12-lead ECGs, were acquired following CRT in 66 consecutive patients...
November 17, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/27862860/incidence-and-predictors-of-permanent-pacemaker-implantation-following-treatment-with-the-repositionable-lotus%C3%A2-transcatheter-aortic-valve
#6
Sarah Zaman, Liam McCormick, Robert Gooley, Hashrul Rashid, Satish Ramkumar, Damon Jackson, Samuel Hui, Ian T Meredith
OBJECTIVES: To determine the incidence and predictors of permanent pacemaker (PPM) requirement following transcatheter aortic valve replacement (TAVR) with the mechanically expanded Lotus(TM) Valve System (Boston Scientific). BACKGROUND: Pacemaker implantation is the most common complication following TAVR. Predictors of pacing following TAVR with the Lotus valve have not been systematically assessed. METHODS: Consecutive patients with severe aortic stenosis who underwent Lotus valve implantation were prospectively recruited at a single-centre...
November 12, 2016: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/27858115/-the-new-esc-guidelines-for-acute-and-chronic-heart-failure-2016
#7
C U Oeing, C Tschöpe, B Pieske
The new guidelines for the diagnosis and treatment of acute and chronic heart failure (HF) were presented in May 2016 during the congress of the Heart Failure Association (HFA) of the European Society of Cardiology (ESC) in Florence. An important amendment affects the classification of HF which now differentiates between HF with preserved ejection fraction (HFpEF) and left ventricular EF (LVEF) > 50%, HF with reduced ejection fraction (HFrEF, LVEF < 40%) and the new entity HF with mid-range ejection fraction (HFmrEF, LVEF 40-49%)...
November 17, 2016: Herz
https://www.readbyqxmd.com/read/27856539/left-ventricular-dimensions-predict-risk-of-appropriate-shocks-but-not-mortality-in-cardiac-resynchronization-therapy-defibrillator-recipients-with-left-bundle-branch-block-and-non-ischemic-cardiomyopathy
#8
Evan C Adelstein, David Schwartzman, Sandeep Jain, Raveen Bazaz, Norman C Wang, Samir Saba
AIMS: Patients with non-ischaemic cardiomyopathy (NICM) and left bundle-branch block (LBBB) often benefit markedly from cardiac resynchronization therapy (CRT). Cardiac resynchronization therapy responders have a lower risk of appropriate device shocks from CRT-defibrillators (CRT-D) than do non-responders. Larger baseline left ventricular (LV) dimensions may be associated with less CRT response and thus greater risk of appropriate shocks. METHODS AND RESULTS: We analysed all (n = 249; 55% female) primary prevention CRT-D recipients at our institution with LBBB, NICM, and measured LV dimensions prior to device implant for the outcomes of (i) appropriate shocks, (ii) any appropriate tachyarrhythmia therapies, and (iii) risk of death, transplant, or left ventricular assist device (LVAD)...
November 17, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/27836874/assessment-of-cardiac-resynchronisation-therapy-in-patients-with-wide-qrs-and-non-specific-intraventricular-conduction-delay-rationale-and-design-of-the-multicentre-randomised-nicd-crt-study
#9
Romain Eschalier, Sylvain Ploux, Bruno Pereira, Nicolas Clémenty, Antoine Da Costa, Pascal Defaye, Stéphane Garrigue, Jean-Baptiste Gourraud, Daniel Gras, Benoît Guy-Moyat, Christophe Leclercq, Pierre Mondoly, Pierre Bordachar
INTRODUCTION: Cardiac resynchronisation therapy (CRT) was initially developed to treat patients with left bundle branch block (LBBB). However, many patients with heart failure have a widened QRS but neither left-BBB nor right-BBB; this is called non-specific intraventricular conduction delay (NICD). It is unclear whether CRT is effective in this subgroup of patients. METHODS AND ANALYSIS: The NICD-CRT study is a prospective, double-blind, randomised (1:1), parallel-arm, multicentre trial comparing the effects of CRT in patients with heart failure, a reduced left ventricular ejection fraction (LVEF <35%) and NICD, who have been implanted with a device (CRT-pacemaker or CRT-defibrillator) that has or has not been activated...
November 11, 2016: BMJ Open
https://www.readbyqxmd.com/read/27797979/prognosis-assessment-of-persistent-left-bundle-branch-block-after-tavi-by-an-electrophysiological-and-remote-monitoring-risk-adapted-algorithm-rationale-and-design-of-the-multicentre-lbbb-tavi-study
#10
Grégoire Massoullié, Pierre Bordachar, Didier Irles, Christophe Caussin, Antoine Da Costa, Pascal Defaye, Frédéric Jean, Alexis Mechulan, Pierre Mondoly, Géraud Souteyrand, Bruno Pereira, Sylvain Ploux, Romain Eschalier
INTRODUCTION: Percutaneous aortic valve replacement (transcatheter aortic valve implantation (TAVI)) notably increases the likelihood of the appearance of a complete left bundle branch block (LBBB) by direct lesion of the LBB of His. This block can lead to high-grade atrioventricular conduction disturbances responsible for a poorer prognosis. The management of this complication remains controversial. METHOD AND ANALYSIS: The screening of LBBB after TAVI persisting for more than 24 hours will be conducted by surface ECG...
October 26, 2016: BMJ Open
https://www.readbyqxmd.com/read/27790494/masquerading-bundle-branch-block-a-poor-prognostic-sign-revisited
#11
Suheil Dhanse, Hashir Kareem, Tom Devasia, Mugula Sudhakar Rao
Masquerading bundle branch block is a rare but important finding on the Electrocardiogram (ECG). It is an indication of severe and diffuse conduction system disease and usually indicates poor prognosis. The precordial leads show a Right Bundle Branch Block (RBBB) pattern while the limb leads resemble a Left Bundle Branch Block (LBBB). This finding on an ECG is almost invariably associated with severe underlying heart disease. It is extremely important to be aware of this finding as it is a marker of poor cardiac outcomes...
September 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27776243/non-responders-to-cardiac-resynchronization-therapy-insights-from-multimodality-imaging-and-electrocardiography-a-brief-review
#12
Patrizia Carità, Egle Corrado, Gianluca Pontone, Antonio Curnis, Luca Bontempi, Giuseppina Novo, Marco Guglielmo, Gianfranco Ciaramitaro, Pasquale Assennato, Salvatore Novo, Giuseppe Coppola
BACKGROUND: Cardiac resynchronization therapy (CRT) is a successful strategy for heart failure (HF) patients. The pre-requisite for the response is the evidence of electrical dyssynchrony on the surface electrocardiogram usually as left bundle branch block (LBBB). Non-response to CRT is a significant problem in clinical practice. Patient selection, inadequate delivery and sub-optimal left ventricle lead position may be important causes. OBJECTIVES: In an effort to improve CRT response multimodality imaging (especially echocardiography, computed tomography and cardiac magnetic resonance) could play a decisive role and extensive literature has been published on the matter...
September 17, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27774266/ecg-as-a-first-step-in-the-detection-of-left-ventricular-systolic-dysfunction-in-the-elderly
#13
Line Lisbeth Olesen, Andreas Andersen
AIMS: Due to the demographic development there is an increasing number of senior citizens with left ventricular systolic dysfunction (LVSD), defined as ejection fraction (EF) < 40%. Unfortunately there are under-diagnosis and under-treatment in the elderly of this serious condition. Echocardiography is the gold standard to diagnose LVSD, but access is limited. Simple screening methods may ensure reduction of undetected cases, and this study investigates if electrocardiogram (ECG) can be used to screen for LVSD in the geriatric population...
March 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27774265/ventricular-conduction-abnormalities-as-predictors-of-long-term-survival-in-acute-de-novo-and-decompensated-chronic-heart-failure
#14
Heli Tolppanen, Krista Siirila-Waris, Veli-Pekka Harjola, David Marono, Jiri Parenica, Philipp Kreutzinger, Tuomo Nieminen, Marie Pavlusova, Tuukka Tarvasmaki, Raphael Twerenbold, Jukka Tolonen, Roman Miklik, Markku S Nieminen, Jindrich Spinar, Christian Mueller, Johan Lassus
AIMS: Data on the prognostic role of left and right bundle branch blocks (LBBB and RBBB), and nonspecific intraventricular conduction delay (IVCD; QRS ≥ 110 ms, no BBB) in acute heart failure (AHF) are controversial. Our aim was to investigate electrocardiographic predictors of long-term survival in patients with de novo AHF and acutely decompensated chronic heart failure (ADCHF). METHODS AND RESULTS: We analysed the admission electrocardiogram of 982 patients from a multicenter European cohort of AHF with 3...
March 2016: ESC Heart Failure
https://www.readbyqxmd.com/read/27762513/etiology-and-left-ventricular-functions-in-left-bundle-branch-block-a-prospective-observational-study
#15
Rajeev Bhardwaj
PURPOSE OF STUDY: Left bundle branch (LBBB) is common ECG finding. Common causes of LBBB are coronary artery disease (CAD), hypertension and dilated cardiomyopathy (DCM). Purpose of the study was to find out the etiology and left ventricular function in patients coming to a territory care hospital. MATERIAL AND METHODS: All consecutive patients coming to our hospital as indoor or outdoor patients with ECG suggestive of LBBB were studied. The detail history and examination was done...
September 2016: Journal of the Association of Physicians of India
https://www.readbyqxmd.com/read/27756040/predictors-of-response-to-cardiac-resynchronization-therapy-a-systematic-review
#16
John Rickard, Henry Michtalik, Ritu Sharma, Zackary Berger, Emmanuel Iyoha, Ariel R Green, Nowreen Haq, Karen A Robinson
BACKGROUND: Multiple studies have sought to determine variables associated with improved "response" to cardiac resynchronization therapy(CRT). Such variables, however, are often derived from inadequately controlled, single center cohort studies calling external validity into question. We sought to determine predictors of response to CRT-D and CRT-P utilizing the methods of systematic review. METHODS: We searched MEDLINE, Embase®, and the Cochrane Central Register of Controlled Trials (CENTRAL) from January 1, 1995, as this is the date of first article reporting use of CRT through October 20, 2014...
September 25, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27753447/high-left-ventricular-lead-sensing-delay-predicts-qrs-narrowing-and-good-response-to-cardiac-resynchronization-therapy
#17
Onur Kaypakli, Mevlüt Koç, Gökhan Gözübüyük, Durmuş Yildiray Şahin
BACKGROUND: Cardiac resynchronization therapy (CRT) was shown to improve heart failure (HF) prognosis. But many patients do not benefit from CRT. Optimization of left ventricular (LV) lead position to the latest activated LV area is important to increase CRT response. We aimed to detect the relationship between LV lead sensing delay and echocardiographic and electrocardiographic response to CRT treatment. METHODS: We prospectively included 156 consecutive patients with HF diagnosis, QRS ≥ 120 ms, left bundle branch block, New York Heart Association II-IV, LV ejection fraction (LVEF) < 35%, and scheduled for CRT (100 male, 56 female; mean age 65...
October 18, 2016: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27752273/reversible-left-bundle-branch-block-should-be-mentioned-in-cardiac-resynchronization-therapy-a-clinical-case-report
#18
Ali Vasheghani-Farahani, Masih Tajdini, Seyed Abolfazl Mohsenizadeh, Seyed Mohammad Reza Hosseini
BACKGROUND: Cardiac resynchronization therapy (CRT) is a medical device to help cardiac synchronized contractility by electrical impulses. Improvement of symptoms and left ventricular systolic function, reducing hospital admissions and mortality in patients with moderate to severe heart failure are the main benefits of administration of cardiac resynchronization therapy. CASE REPORT: In this article, we describe a case of heart failure and left bundle branch block (LBBB) who was candidate for cardiac resynchronization therapy; but after managing hyperkalemia, left bundle branch block resolved, ejection fraction increased and cardiac resynchronization therapy implantation was canceled...
May 2016: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/27747171/cardiocutaneous-syndrome-naxos-disease-in-a-bangladeshi-boy
#19
Akm Monwarul Islam, Md Toufiqur Rahman, Abu Hana Chowdhury
Naxos disease is a rare autosomal recessive form of arrhythmogenic right ventricular cardiomyopathy (ARVC) with woolly hair and palmoplantar keratoderma. The cardiomyopathy presents by adolescence with syncope, ventricular tachycardia (VT) of left bundle branch block (LBBB) morphology, and/or ventricular fibrillation. The diagnosis and management of ARVC are at present in evolution; the recently published modified Task Force Criteria for diagnosis and International Task Force consensus statement for treatment of ARVC will hopefully bring about uniformity in recognition and management of Naxos disease as well...
October 2016: Cardiovascular Diagnosis and Therapy
https://www.readbyqxmd.com/read/27733459/catheter-ablation-for-ventricular-tachycardia-following-surgical-treatment-of-pulmonary-stenosis-with-intact-ventricular-septum
#20
Bingbo Hou, Lihui Zheng, Guodong Niu, Lingmin Wu, Yu Qiao, Wei Sun, Ligang Ding, Gang Chen, Shu Zhang, Reginald Liew, Yan Yao
AIMS: This study was aimed to report the characteristics and treatment of ventricular tachycardia (VT) following surgical treatment of pulmonary stenosis with intact ventricular septum. METHODS AND RESULTS: Five patients underwent radiofrequency catheter ablation for sustained monomorphic left bundle branch block (LBBB) type VT who previously underwent surgical treatment of pulmonary stenosis. Except stimulation, voltage and activation mapping was performed using three-dimensional (3D) electro-anatomic mapping and ablation was applied accordingly...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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