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https://www.readbyqxmd.com/read/29762239/quality-and-safety-in-health-care-part-xliv-cardiac-resynchronization-therapy-and-subcutaneous-defibrillator-implantable-devices
#1
Jay A Harolds
This article discusses 2 specialized implantable cardioverter defibrillator (ICD) devices. A special type of implantable device is available for cardiac resynchronization therapy, which can also have a defibrillator, in which case it is called a CRT-D device. In patients who meet guidelines for eligibility, a CRT-D will diminish the number of significant cardiac events including death. A subcutaneous ICD device does not need any leads placed in the vascular system and therefore does not have some of the complications that may be seen with transvenous ICDs...
May 14, 2018: Clinical Nuclear Medicine
https://www.readbyqxmd.com/read/29761679/gender-related-differences-in-outcomes-of-patients-with-cardiac-resynchronization-therapy
#2
Roman Nevzorov, Avital Porter, Shanie Mostov, Shirit Kazum, Alon Eisen, Gustavo Goldenberg, Zaza Iakobishvili, Jairo Kusniec, Gregory Golovchiner, Boris Strasberg, Moti Haim
BACKGROUND: Gender-related differences (GRD) exist in the outcome of patients with cardiac resynchronization therapy (CRT). OBJECTIVES: To assess GRD in patients who underwent CRT. METHODS: A retrospective cohort of 178 patients who were implanted with a CRT in a tertiary center 2005-2009 was analyzed. Primary outcome was 1 year mortality. Secondary endpoints were readmission and complication rates. RESULTS: No statistically significant difference was found in 1 year mortality rates (14...
May 2018: Israel Medical Association Journal: IMAJ
https://www.readbyqxmd.com/read/29759832/safety-and-efficacy-of-multipoint-pacing-in-cardiac-resynchronization-therapy-the-multipoint-pacing-trial
#3
Imran Niazi, James Baker, Raffaele Corbisiero, Charles Love, David Martin, Robert Sheppard, Seth J Worley, Niraj Varma, Kwangdeok Lee, Gery Tomassoni
OBJECTIVES: The MultiPoint Pacing (MPP) trial assessed the safety and efficacy of pacing 2 left ventricular sites with a quadripolar lead in patients with heart failure indicated for a CRT-D device. BACKGROUND: Cardiac resynchronization therapy nonresponse is a complex problem where stimulation of multiple left ventricular sites may be a solution. METHODS: Enrolled patients were indicated for a CRT-D system. Bi-ventricular (Bi-V) pacing was activated at implant...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29757390/battery-longevity-of-implantable-cardioverter-defibrillators-and-cardiac-resynchronization-therapy-defibrillators-technical-clinical-and-economic-aspects-an-expert-review-paper-from-ehra
#4
Giuseppe Boriani, Josè Merino, David J Wright, Fredrik Gadler, Beat Schaer, Maurizio Landolina
In recent years an extension of devices longevity has been obtained for implantable cardioverter-defibrillators (ICDs), including ICDs for cardiac resynchronization therapy (CRT-D) through improved battery chemistry and device technology and this implies important clinical benefits (reduced need for device replacements and associated complications, particularly infections), as well as economic benefits, in line with patient preferences and needs. From a clinical point of view, the availability of this improvement in technology allows to better tune the choice of the device to be implanted, taking into account that the reasons supporting the value of an extended device longevity as a clinical priority may differ according to the clinical setting (purely electrical diseases or left ventricular dysfunction/heart failure, respectively)...
May 10, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29754922/cardiac-resynchronization-therapy-in-the-ageing-population-with-or-without-an-implantable-defibrillator
#5
Michael Döring, Micaela Ebert, Nikolaos Dagres, Andreas Müssigbrodt, Kerstin Bode, Helge Knopp, Michael Kühl, Gerhard Hindricks, Sergio Richter
BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment option for systolic heart failure, but the benefit of an additional implantable cardioverter-defibrillator (ICD) in elderly patients is not well established. The aim of our study was to evaluate the impact of an additional ICD on survival in elderly CRT recipients. METHODS: Patients aged ≥75 years with an indication for CRT and primary preventive ICD therapy, which underwent implantation of either a CRT-pacemaker (CRT-P) or CRT-defibrillator (CRT-D) were included in the study...
July 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29740728/transvenous-cardiac-implantable-electronic-device-implantation-in-patients-with-persistent-left-superior-vena-cava-in-a-tertiary-center
#6
Xueying Chen, Ziqing Yu, Jin Bai, Wei Wang, Shengmei Qin, Jingfeng Wang, Zhe Sun, Fei Han, Yangang Su, Junbo Ge
PURPOSE: Persistent left superior vena cava (PLSVC) is rare and often asymptomatic, which might cause difficulties in the implantation of cardiac implantable electronic devices (CIEDs). The aim of this study was to determine the prevalence of PLSVC and to study the clinical characteristics and significance of PLSVC in patients with CIED implantation. METHODS: Thirty-three patients with PLSVC were collected from 7047 CIED recipients over recent 10 years in our center...
May 9, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29721113/long-term-outcomes-of-heart-failure-patients-who-received-primary-prevention-implantable-cardioverter-defibrillator-an-observational-study
#7
Khang-Li Looi, Karishma Sidhu, Lisa Cooper, Liane Dawson, Debbie Slipper, Andrew Gavin, Nigel Lever
Background: Implantable cardioverter-defibrillator (ICD) therapy is indicated for selected heart failure patients for the primary prevention of sudden cardiac death. Little is known about the outcomes in patients selected for primary prevention device therapy in the northern region of New Zealand. Method: Heart failure patients with systolic dysfunction who underwent primary prevention ICD/cardiac resynchronization therapy-defibrillator (CRT-D) implantation between January 1, 2007, and June 1, 2015, were included...
February 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29700054/ventricular-electrical-delay-measured-from-body-surface-ecgs-is-associated-with-cardiac-resynchronization-therapy-response-in-left-bundle-branch-block-patients-from-the-madit-crt-trial-multicenter-automatic-defibrillator-implantation-cardiac-resynchronization
#8
Filip Plesinger, Pavel Jurak, Josef Halamek, Petr Nejedly, Pavel Leinveber, Ivo Viscor, Vlastimil Vondra, Scott McNitt, Bronislava Polonsky, Arthur J Moss, Wojciech Zareba, Jean-Philippe Couderc
BACKGROUND: Although cardiac resynchronization therapy (CRT) is beneficial in heart failure patients with left bundle branch block, 30% of these patients do not respond to the therapy. Identifying these patients before implantation of the device is one of the current challenges in clinical cardiology. METHODS: We verified the diagnostic contribution and an optimized computerized approach to measuring ventricular electrical activation delay (VED) from body surface 12-lead ECGs...
May 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29697764/long-term-clinical-outcomes-of-cardiac-resynchronization-therapy-with-or-without-defibrillation-impact-of-the-aetiology-of-cardiomyopathy
#9
Francisco Leyva, Abbasin Zegard, Fraz Umar, Robin James Taylor, Edmund Acquaye, Christopher Gubran, Shajil Chalil, Kiran Patel, Jonathan Panting, Howard Marshall, Tian Qiu
Aims: There is a continuing debate as to whether cardiac resynchronization therapy-defibrillation (CRT-D) is superior to CRT-pacing (CRT-P), particularly in patients with non-ischaemic cardiomyopathy (NICM). We sought to quantify the clinical outcomes after primary prevention of CRT-D and CRT-P and identify whether these differed according to the aetiology of cardiomyopathy. Methods and results: Analyses were undertaken in the total study population of patients treated with CRT-D (n = 551) or CRT-P (n = 999) and in propensity-matched samples...
April 25, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29657589/prognostic-significance-of-nonsustained-ventricular-tachycardia-in-patients-receiving-cardiac-resynchronization-therapy-for-primary-prevention-analysis-of-the-japan-cardiac-device-treatment-registry-database
#10
Hisashi Yokoshiki, Akihiko Shimizu, Takeshi Mitsuhashi, Hiroshi Furushima, Yukio Sekiguchi, Tetsuyuki Manaka, Nobuhiro Nishii, Takeshi Ueyama, Norishige Morita, Hideo Okamura, Takashi Nitta, Kenzo Hirao, Ken Okumura
Background: Whether nonsustained ventricular tachycardia (NSVT) is a marker of increased risk of sustained ventricular tachyarrhythmias (VTAs) remains to be established in patients receiving cardiac resynchronization therapy with a defibrillator (CRT-D) for primary prevention. Methods: Among the follow-up data of the Japan cardiac device treatment registry (JCDTR) with an implantation date between January 2011 and August 2015, information regarding a history of NSVT before the CRT-D implantation for primary prevention had been registered in 269 patients...
April 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29628471/a-case-of-a-cardiac-resynchronization-therapy-defibrillator-exhibiting-a-lower-and-alternately-variable-basic-rate
#11
Keigo Iwazaki, Toshiya Kojima, Takahide Murasawa, Jun Yokota, Hikaru Tanimoto, Jun Matsuda, Nobuaki Fukuma, Takumi Matsubara, Yu Shimizu, Gaku Oguri, Eriko Hasumi, Hitoshi Kubo, Kyungho Chang, Katsuhito Fujiu, Issei Komuro
A cardiac resynchronization therapy defibrillator (CRT-D) (Medtronic Inc. Protecta XT) was implanted in a 67-year-old man who had cardiac sarcoidosis with extremely low cardiac function. He had ventricular tachycardia which was controlled by catheter ablation, medication and pacing. The programmed mode was DDI, lower rate was 90 beats/minute, paced AV delay was 150 ms, and the noncompetitive atrial pacing (NCAP) function was programmed as 300 ms.After his admission for pneumonia and heart failure, we changed his DDI mode to a DDD mode because he had atrial tachycardia, which led to inadequate bi-ventricular pacing...
April 6, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29627955/t-wave-positivity-in-lead-avr-is-associated-with-mortality-in-patients-with-cardiac-resynchronization-therapy
#12
Yahya Kemal İçen, Yurdaer Dönmez, Hasan Koca, Mehmet Uğurlu, Mevlüt Koç
PURPOSE: Positive T wave polarity in lead aVR (TPaVR) is associated with a poor prognostic indicator in patients with heart failure reduce ejection fraction (HFrEF). Our aim was to investigate the relationship between positive TPaVR and mortality in patients with cardiac resynchronization therapy defibrillator (CRT-D). METHODS: We included retrospectively 224 HFrEF patients with CRT-D in sinus rhythm. Laboratory, electrocardiographic (ECG), and echocardiographic data were recorded...
April 8, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29625702/comparison-of-long-term-survival-benefits-with-cardiac-resynchronization-therapy-in-patients-with-mild-heart-failure-with-versus-without-diabetes-mellitus-from-the-multicenter-automatic-defibrillator-implantation-trial-with-cardiac-resynchronization-therapy
#13
Valentina Kutyifa, Syed Yaseen Naqvi, Mary Brown, Scott McNitt, Ilan Goldenberg, Helmut Klein, Arthur J Moss
We have previously shown a reduction in HF events with cardiac resynchronization therapy with defibrillator (CRT-D) in patients with mild heart failure (HF) and diabetes mellitus (DM). It remains unknown whether HF remission in DM patients with CRT-D translates into reduced mortality. The effects of CRT-D versus an implantable cardioverter-defibrillator (ICD) alone to reduce long-term mortality were assessed in patients with left bundle branch block with DM (n = 386) and without DM (n = 982), enrolled in the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resynchronization Therapy (MADIT-CRT)...
March 14, 2018: American Journal of Cardiology
https://www.readbyqxmd.com/read/29622978/obesity-paradox-in-heart-failure-patients-female-gender-characteristics-kamc-single-center-experience
#14
Sheeren Khaled, Rajaa Matahen
Background/Introduction: The correlation between low body mass index (BMI) and congestive heart failure (obesity paradox) has been described in the literature; However, the association between BMI and clinical outcome measures is not well characterized. Little is known about CHF in the Middle Eastern female population; most of the gender-specific information on heart failure comes from higher income "Western" countries. Objectives: We aimed to identify the correlation between heart failure patients especially those with low BMI and clinical/safety outcome measures with focusing on female patients subgroup characteristics...
September 2017: The Egyptian heart journal: (EHJ): official bulletin of the Egyptian Society of Cardiology
https://www.readbyqxmd.com/read/29604094/cardiac-resynchronization-therapy-is-associated-with-a-reduction-in-icd-therapies-while-improves-ventricular-function
#15
Enrique Galve, Gerard Oristrell, Gabriel Acosta, Aida Ribera-Solé, Àngel Moya-Mitjans, Ignacio Ferreira-González, Jordi Pérez-Rodon, David García-Dorado
BACKGROUND: Repeated implantable cardioverter-defibrillator (ICD) therapies cause myocardial damage and thus, an increased risk of arrhythmias and mortality. HYPOTHESIS: Cardiac resynchronization therapy-defibrillator (CRT-D) reduces the number of appropriate therapies in patients with left ventricular dysfunction (LVEF < 50%). METHODS: The retrospective study involved 175 consecutive patients (age 64.6±10.4 years, 86.9% men) with reduced LVEF 27...
March 31, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29596906/atrial-electrogram-quality-in-single-pass-defibrillator-leads-with-floating-atrial-bipole-in-patients-with-permanent-atrial-fibrillation-and-cardiac-resynchronization-therapy
#16
Christian Sticherling, Dirk Müller, Beat A Schaer, Silke Krüger, Christof Kolb
Many patients receiving cardiac resynchronization therapy (CRT) suffer from permanent atrial fibrillation (AF). Knowledge of the atrial rhythm is important to direct pharmacological or interventional treatment as well as maintaining AV-synchronous biventricular pacing if sinus rhythm can be restored. A single pass single-coil defibrillator lead with a floating atrial bipole has been shown to obtain reliable information about the atrial rhythm but has never been employed in a CRT-system. The purpose of this study was to assess the feasibility of implanting a single coil right ventricular ICD lead with a floating atrial bipole and the signal quality of atrial electrograms (AEGM) in CRT-defibrillator recipients with permanent AF...
March 26, 2018: Indian Pacing and Electrophysiology Journal
https://www.readbyqxmd.com/read/29578202/the-impact-of-the-left-ventricular-pacing-polarity-and-localization-during-cardiac-resynchronization-therapy-on-depolarization-and-repolarization-parameters
#17
Emin Evren Özcan, Ali Öztürk, Erdem Özel, Ömer Senarslan, Bela Merkely, Laszlo Geller
OBJECTIVE: Reversal of myocardial activation sequence during cardiac resynchronization therapy (CRT) may increase the transmural dispersion of repolarization (TDR), which may lead to ventricular arrhythmias. Quadripolar left ventricular (LV) leads offer 10 different pacing configurations. However, little is known about the role of pacing polarity on repolarization patterns. Our study aimed to investigate the impact of LV pacing polarity on depolarization and repolarization parameters in the same substrate in the same patient group...
March 21, 2018: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/29572715/right-ventricular-lead-location-right-left-ventricular-lead-interaction-and-long-term-outcomes-in-cardiac-resynchronization-therapy-patients
#18
Usama A Daimee, Helmut U Klein, Michael C Giudici, Wojciech Zareba, Scott McNitt, Bronislava Polonsky, Arthur J Moss, Valentina Kutyifa
BACKGROUND: The effects of right ventricular (RV) lead location and the combination of RV and left ventricular (LV) lead locations on long-term outcomes in patients receiving cardiac resynchronization therapy with defibrillator (CRT-D) are not well understood. METHODS: Our cohort consisted of 743 CRT-D patients from MADIT-CRT. We evaluated long-term death and combined heart failure or death (HF/death) in patients with non-apical RV vs. apical RV leads. We further assessed these long-term outcomes based on the combination of RV and LV leads, termed "RV-LV lead interaction...
March 23, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/29540431/device-complications-with-addition-of-defibrillation-to-cardiac-resynchronisation-therapy-for-primary-prevention
#19
Sérgio Barra, Rui Providência, Serge Boveda, Rudolf Duehmke, Kumar Narayanan, Anthony W Chow, Olivier Piot, Didier Klug, Pascal Defaye, Daniel Gras, Jean-Claude Deharo, Paul Milliez, Antoine Da Costa, Pierre Mondoly, Jorge Gonzalez-Panizo, Christophe Leclercq, Patrick Heck, Munmohan Virdee, Nicolas Sadoul, Jean-Yves Le Heuzey, Eloi Marijon
OBJECTIVE: In patients indicated for cardiac resynchronisation therapy (CRT), the choice between a CRT-pacemaker (CRT-P) versus defibrillator (CRT-D) remains controversial and indications in this setting have not been well delineated. Apart from inappropriate therapies, which are inherent to the presence of a defibrillator, whether adding defibrillator to CRT in the primary prevention setting impacts risk of other acute and late device-related complications has not been well studied and may bear relevance for device selection...
March 14, 2018: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/29531592/electrocardiographic-parameters-as-predictors-of-response-to-cardiac-resynchronization-therapy
#20
Lidija Poposka, Vladimir Boskov, Dejan Risteski, Jane Taleski, Filip Janusevski, Elizabeta Srbinovska, Ljubica Georgievska-Ismail
INTRODUCTION: Although strict selection criteria are used to select patients for cardiac resynchronisation therapy, up to 30% of patients do not have a positive clinical response. PATIENTS: A total of 102 consecutive patients who had biventricular pacemaker/defibrillator (CRT-P or CRT-D) implanted were enrolled in this prospective observational study. RESULTS: During the average follow-up period of 24.3 months 5 patients died and 17 (16.7%) patients were hospitalised with the symptoms of heart failure; 75 (73...
February 15, 2018: Open Access Macedonian Journal of Medical Sciences
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