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https://www.readbyqxmd.com/read/27920838/successful-resynchronization-by-permanent-his-bundle-pacing-in-a-patient-with-pacing-induced-cardiomyopathy
#1
Yoji Iida, Tomoaki Izawa, Chikara Kobari, Toru Yatsuhashi, Nobuyuki Makishima
Right ventricular (RV) pacing has been reported to result in ventricular dyssynchrony, heart failure, and increased mortality. Pacing associated deterioration of left ventricular (LV) systolic function has been termed pacing-induced cardiomyopathy (PICM). While upgrading to biventricular pacing (BiVP) is an effective therapy for PICM, permanent His-bundle pacing (HBP) can be a physiological alternative to BiVP. We present a patient with PICM who responded dramatically to permanent HBP.
December 2016: Journal of Arrhythmia
https://www.readbyqxmd.com/read/27912199/right-ventricular-dyssynchrony-predicts-clinical-outcomes-in-patients-with-pulmonary-hypertension
#2
Mitsushige Murata, Toshimitsu Tsugu, Takashi Kawakami, Masaharu Kataoka, Yugo Minakata, Jin Endo, Hikaru Tsuruta, Yuji Itabashi, Yuichiro Maekawa, Keiichi Fukuda
BACKGROUND: RV dyssynchrony has been described in patients with pulmonary hypertension (PH) and is an independent predictor of clinical worsening; however, the optimal method for measuring RV dyssynchrony has not been fully established. This study aimed to investigate whether RV dyssynchrony is correlated with hemodynamics and prognosis in PH patients and to identify the best parameter for evaluating RV dyssynchrony. METHODS: This study assessed 100 PH patients, measuring mean pulmonary artery pressure (mPAP), pulmonary vascular resistance (PVR), and cardiac index (CI) by right heart catheterization (RHC)...
November 14, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27909478/cardiac-resynchronization-therapy-in-non-ischemic-cardiomyopathy
#3
REVIEW
Miriam Shanks Md PhD, Victoria Delgado Md PhD, Jeroen J Bax Md PhD
Cardiac resynchronization therapy (CRT) is an established therapy for heart failure patients who remain symptomatic despite optimal medical therapy, have reduced left ventricular ejection fraction (<35%) and wide QRS duration (>120 ms), preferably with left bundle branch block morphology. The response to CRT depends on the cardiac substrate: presence of correctable left ventricular mechanical dyssynchrony, presence of myocardial fibrosis (scar) and position of the left ventricular pacing lead. Patients with non-ischemic cardiomyopathy have shown higher response rates to CRT compared with patients with ischemic cardiomyopathy...
February 2016: Journal of Atrial Fibrillation
https://www.readbyqxmd.com/read/27906653/longer-left-ventricular-electric-delay-reduces-mitral-regurgitation-after-cardiac-resynchronization-therapy-mechanistic-insights-from-the-smart-av-study-smartdelay-determined-av-optimization-a-comparison-to-other-av-delay-methods-used-in-cardiac-resynchronization
#4
Neal A Chatterjee, Michael R Gold, Alan D Waggoner, Michael H Picard, Kenneth M Stein, Yinghong Yu, Timothy E Meyer, Nicholas Wold, Kenneth A Ellenbogen, Jagmeet P Singh
BACKGROUND: Mitral regurgitation (MR) is associated with worse survival in those undergoing cardiac resynchronization therapy (CRT). Left ventricular (LV) lead position in CRT may ameliorate mechanisms of MR. We examine the association between a longer LV electric delay (QLV) at the LV stimulation site and MR reduction after CRT. METHODS AND RESULTS: QLV was assessed retrospectively in 426 patients enrolled in the SMART-AV study (SmartDelay Determined AV Optimization: A Comparison to Other AV Delay Methods Used in CRT)...
November 2016: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/27890282/selective-versus-non-selective-his-bundle-pacing-for-cardiac-resynchronization-therapy
#5
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/27886934/coronary-sinus-lead-positioning
#6
REVIEW
Attila Roka, Rasmus Borgquist, Jagmeet Singh
Although cardiac resynchronization therapy improves morbidity and mortality in patients with cardiomyopathy, heart failure, and electrical dyssynchrony, the rate of nonresponders using standard indications and implant techniques is still high. Optimal coronary sinus lead positioning is important to increase the chance of successful resynchronization. Patient factors such as cause of heart failure, type of dyssynchrony, scar burden, coronary sinus anatomy, and phrenic nerve capture may affect the efficacy of the therapy...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886930/cellular-and-molecular-aspects-of-dyssynchrony-and-resynchronization
#7
REVIEW
Jonathan A Kirk, David A Kass
Dyssynchronous contraction of the ventricle significantly worsens morbidity and mortality in patients with heart failure (HF). Approximately one-third of patients with HF have cardiac dyssynchrony and are candidates for cardiac resynchronization therapy (CRT). The initial understanding of dyssynchrony and CRT was in terms of global mechanics and hemodynamics, but lack of clinical benefit in a sizable subgroup of recipients who appear otherwise appropriate has challenged this paradigm. This article reviews current understanding of these cellular and subcellular mechanisms, arguing that these aspects are key to improving CRT use, as well as translating its benefits to a wider HF population...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886924/how-to-improve-cardiac-resynchronization-therapy-benefit-in-atrial-fibrillation-patients-pulmonary-vein-isolation-and-beyond
#8
REVIEW
Carola Gianni, Luigi Di Biase, Sanghamitra Mohanty, Yalçın Gökoğlan, Mahmut Fatih Güneş, Amin Al-Ahmad, J David Burkhardt, Andrea Natale
Although cardiac resynchronization therapy (CRT) is an important treatment of symptomatic heart failure patients in sinus rhythm with low left ventricular ejection fraction and ventricular dyssynchrony, its role is not well defined in patients with atrial fibrillation (AF). CRT is not as effective in patients with AF because of inadequate biventricular capture and loss of atrioventricular synchrony. Both can be addressed with catheter ablation of AF. It is still unclear if these therapies offer additive benefits in patients with ventricular dyssynchrony...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886923/atrioventricular-node-ablation
#9
REVIEW
Maurizio Gasparini
Cardiac resynchronization therapy (CRT) is a device-based, nonpharmacologic approach that has shown to improve the outcome in patients with heart failure in terms of mortality and morbidity reduction. Large randomized trials have virtually enrolled patients in New York Heart Association class III-IV, with reduced left ventricular ejection fraction, with evidence of electrical dyssynchrony, and receiving optimal medical therapy and who were in sinus rhythm. Guidelines remain imprecise as to defining differentiated approaches according to the forms of atrial fibrillation other than permanent...
January 2017: Heart Failure Clinics
https://www.readbyqxmd.com/read/27886918/cardiac-resynchronization-therapy-an-overview-on-guidelines
#10
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/27867072/changes-in-electrical-dyssynchrony-by-body-surface-mapping-predict-left-ventricular-remodeling-in-cardiac-resynchronization-therapy-patients
#11
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/27862715/effect-of-cardiac-resynchronization-therapy-in-patients-with-diabetes-randomized-in-echocrt
#12
REVIEW
Matthias P Nägele, Jan Steffel, Michele Robertson, Jagmeet P Singh, Andreas J Flammer, Jeroen J Bax, Jeffrey S Borer, Kenneth Dickstein, Ian Ford, John Gorcsan, Daniel Gras, Henry Krum, Peter Sogaard, Johannes Holzmeister, William T Abraham, Josep Brugada, Frank Ruschitzka
AIMS: As patients with heart failure (HF) and concomitant diabetes carry a poor prognosis, this post-hoc subgroup analysis aimed to compare the outcomes of patients with and without diabetes randomized in the Echocardiography Guided Cardiac Resynchronization Therapy (EchoCRT) study. METHODS AND RESULTS: EchoCRT randomized patients with a QRS duration <130 ms and echocardiographic evidence of left ventricular dyssynchrony to CRT turned on (CRT=ON) vs. off (CRT=OFF) following device implantation...
November 11, 2016: European Journal of Heart Failure
https://www.readbyqxmd.com/read/27858344/association-between-non-perfusion-parameters-and-presence-of-ischemia-in-gated-spect-myocardial-perfusion-imaging-studies
#13
Amalia Peix, Lázaro O Cabrera, Kenia Padrón, Lydia Rodríguez, Jesús Fernández, Giselle López, Regla Carrillo, Erick Mena, Yoel Fernández, Maurizio Dondi, Diana Páez
BACKGROUND: Combined assessment of perfusion and function improves diagnostic and prognostic power of gated-SPECT in patients with coronary artery disease. The aim of this study was to investigate whether the presence of stress-induced ischemia is associated with abnormal resting left ventricular (LV) function and intraventricular dyssynchrony. METHODS AND RESULTS: Gated-SPECT myocardial perfusion imaging (MPI) at rest and 15 min post-stress was performed in 101 patients, who were divided into three groups: those with stress-induced ischemia (Group 1, n = 58), those with normal scans (Group 2, n = 28), and those with scar but no ischemia (Group 3, n = 15)...
November 17, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27843504/relationship-between-patients-with-clinical-auditory-neuropathy-spectrum-disorder-and-mutations-in-gjb2-gene
#14
Guilherme M de Carvalho, Priscila Z Ramos, Arthur M Castilho, Alexandre C Guimarães, Edi L Sartorato
: The auditory neuropathy is a condition which there is a dyssynchrony in the nerve conduction of the auditory nerve fibers. There is no evidence about the relationship between patients with clinical auditory neuropathy spectrum disorder and mutations in GJB2 gene. There are only two studies about this topic in the medical literature. Connexin 26 (GJB2 gene) mutations are common causes of genetic deafness in many populations and we also being reported in subjects with auditory neuropathy...
2016: Open Neurology Journal
https://www.readbyqxmd.com/read/27842752/management-of-sedation-and-paralysis
#15
REVIEW
Michael A Fierro, Raquel R Bartz
Sedatives are administered to decrease patient discomfort and agitation during mechanical ventilation and to maintain patient-ventilator synchrony. Titration of infusions and or bolus dosing to maintain light sedation goals according to validated scales is recommended. However, it is important to consider deeper sedation for patients with refractory patient-ventilator dyssynchrony (PVD) to prevent volutrauma and barotrauma. Deep sedation plus muscle relaxants may be required to treat PVD or to reduce oxygen consumption and carbon dioxide production...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27842746/managing-respiratory-failure-in-obstructive-lung-disease
#16
REVIEW
Stephen P Bergin, Craig R Rackley
Exacerbations of obstructive lung disease are common causes of acute respiratory failure. Short-acting bronchodilators and systemic glucocorticoids are the foundation of pharmacologic management. For patients requiring ventilator support, use of noninvasive ventilation reduces the risk of mortality and progression to invasive mechanical ventilation. Challenges associated with invasive ventilation include ventilator dyssynchrony, air trapping, and dynamic hyperinflation. Careful monitoring and adjustment of ventilatory support parameters helps to optimize the patient-ventilator interaction and minimizes the risk of associated morbidity...
December 2016: Clinics in Chest Medicine
https://www.readbyqxmd.com/read/27833309/normal-values-of-cardiac-mechanical-synchrony-parameters-using-gated-myocardial-perfusion-single-photon-emission-computed-tomography-impact-of-population-and-study-protocol
#17
Anirban Mukherjee, Harmandeep Singh, Chetan Patel, Gautam Sharma, Ambuj Roy, Nitish Naik
PURPOSE OF THE STUDY: Normal values of cardiac mechanical synchrony parameters in gated myocardial perfusion single-photon emission computed tomography (GMPS) are well established in literature from the Western population. The aim of the study is to establish normal values of mechanical synchrony with GMPS in Indian population and to find out whether it differs significantly from established values. PROCEDURE: We retrospectively analyzed 1 day low-dose stress/high-dose rest GMPS studies of 120 patients (sixty males, 52 ± 11...
October 2016: Indian Journal of Nuclear Medicine: IJNM: the Official Journal of the Society of Nuclear Medicine, India
https://www.readbyqxmd.com/read/27826774/left-ventricular-mechanical-dyssynchrony-graduation-of-myocardial-perfusion-gated-spect-phase-analysis-what-next
#18
EDITORIAL
Nili Zafrir
No abstract text is available yet for this article.
November 8, 2016: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/27823600/radiotherapy-induced-cardiac-implantable-electronic-device-dysfunction-in-patients-with-cancer
#19
Rodrigo Bagur, Mathilde Chamula, Émilie Brouillard, Caroline Lavoie, Luis Nombela-Franco, Anne-Sophie Julien, Louis Archambault, Nicolas Varfalvy, Valérie Gaudreault, Sébastien X Joncas, Zeev Israeli, Yasir Parviz, Mamas A Mamas, Shahar Lavi
Radiotherapy can affect the electronic components of a cardiac implantable electronic device (CIED) resulting in malfunction and/or damage. We sought to assess the incidence, predictors, and clinical impact of CIED dysfunction (CIED-D) after radiotherapy for cancer treatment. Clinical characteristics, cancer, different types of CIEDs, and radiation dose were evaluated. The investigation identified 230 patients, mean age 78 ± 8 years and 70% were men. A total of 199 patients had pacemakers (59% dual chamber), 21 (9%) cardioverter-defibrillators, and 10 (4%) resynchronizators or defibrillators...
October 7, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/27818478/three-dimensional-speckle-tracking-imaging-for-assessing-left-atrial-function-in-hypertensive-patients-with-paroxysmal-atrial-fibrillation
#20
Atsuko Furukawa, Katsuhisa Ishii, Eiichi Hyodo, Megumi Shibamoto, Akihiro Komasa, Takahiro Nagai, Eiji Tada, Yutaka Seino, Junichi Yoshikawa
Hypertension (HT) is known to be the most prevalent risk factor for paroxysmal atrial fibrillation (PAF), however, its mechanisms have not been fully clarified. Our aim was to investigate the differences in left atrial (LA) function between healthy subjects, and hypertensive patients without PAF (HT-PAF(-)) and with PAF (HT-PAF(+)) using 3-dimensional (3D) speckle tracking imaging (STI). A total of 144 subjects were enrolled: 44 HT-PAF(+) (27 males; mean age 69 ± 10 years), 50 HT-PAF(-) (31 males; mean age 63 ± 11 years), and 50 controls (31 males; mean age 51 ± 14 years)...
November 4, 2016: International Heart Journal
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