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Biventricular Pacing

Mohamed Abdelrahman, Faiz A Subzposh, Dominik Beer, Brendan Durr, Angela Naperkowski, Haiyan Sun, Jess W Oren, Gopi Dandamudi, Pugazhendhi Vijayaraman
BACKGROUND: Right ventricular pacing (RVP) is associated with heart failure and increased mortality. His bundle pacing (HBP) is a physiological alternative to RVP. OBJECTIVE: The aim of the study is to evaluate clinical outcomes of HBP compared to RVP. METHODS: All patients requiring initial pacemaker implantation between Oct 1st , 2013 and December 31st , 2016 were included in the study. Permanent HBP was attempted in consecutive patients at one hospital and RVP at a sister hospital...
March 5, 2018: Journal of the American College of Cardiology
Alessandro Proclemer, Massimo Zecchin, Antonio D'Onofrio, Giuseppe Boriani, Domenico Facchin, Luca Rebellato, Marco Ghidina, Giulia Bianco, Emanuela Bernardelli, Elsa Pucher, Dario Gregori
BACKGROUND: The pacemaker (PM) and implantable cardioverter-defibrillator (ICD) registry of the Italian Association of Arrhythmology and Cardiac Pacing (AIAC) monitors the main epidemiological data in real-world practice. The survey for the 2016 activity collects information about demographics, clinical characteristics, main indications for PM/ICD therapy and device types from the Italian collaborating centers. METHODS: The registry collects prospectively national PM and ICD implantation activity on the basis of European cards...
February 2018: Giornale Italiano di Cardiologia
Abdulcebbar Şipal, Serdar Bozyel, Müjdat Aktaş, Emir Derviş, Tayyar Akbulut, Onur Argan, Umut Çelikyurt, Dilek Ural, Tayfun Şahin, Ayşen Ağır, Ahmet Vural
OBJECTIVE: Failure to select the optimal left ventricular (LV) segment for lead implantation is one of the most important causes of unresponsiveness to the cardiac resynchronization therapy (CRT). In our study, we aimed to investigate the echocardiographic and clinical benefits of LV lead implantation guided by an intraoperative 12-lead surface electrocardiogram (ECG) in patients with multiple target veins. METHODS: We included 80 [42 (62.5%) male] heart failure patients who successfully underwent CRT defibrillator (CRT-D) implantation...
March 2018: Anatolian Journal of Cardiology
Hamza Sunman, Uğur Canpolat, Hikmet Yorgun, Adem Özkan, Muhammet Ulvi Yalçın, Tülin Bayrak, Levent Şahiner, Ergün Barış Kaya, Asuman Özkara, Kudret Aytemir, Ali Oto
OBJECTIVE: Cardiac resynchronization therapy (CRT) induces structural and electrical reverse remodeling of the failing heart. However, the association between native QRS narrowing and cardiac fibrosis markers has not been investigated in patients with an implanted CRT device. METHODS: A total of 41 symptomatic patients diagnosed with systolic heart failure who underwent CRT implantation were included in this study. Electrocardiogram findings and cardiac fibrosis marker levels [galectin-3, growth-differentiation factor-15 (GDF-15) and procollagen III N-terminal propeptide (P3TD)] were collected before and 12 months after initiation of biventricular pacing...
March 2018: Türk Kardiyoloji Derneği Arşivi: Türk Kardiyoloji Derneğinin Yayın Organıdır
Neal A Chatterjee, E Kevin Heist
Cardiac resynchronization therapy (CRT) is an important therapeutic tool in the management of patients with heart failure and electrical dyssynchrony. In appropriately selected patients, landmark randomized controlled trials have demonstrated morbidity and mortality benefit beyond standard goal-directed medical therapy. Current guidelines emphasize the greatest clinical efficacy of CRT in patients with symptomatic heart failure, left bundle branch block, and wide QRS duration (> 150 ms). Other relevant considerations include the presence of atrial fibrillation, the presence of AV block, the etiology of cardiomyopathy, the presence of masked left-sided conduction delay, and the impact of comorbidities that might predict poor clinical response...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
William A Huang, Maereg A Wassie, Olujimi A Ajijola
His bundle pacing (HBP) has been shown to be a feasible, beneficial, and safe way to achieve cardiac resynchronization therapy (CRT) with recruitment of the heart's physiological conduction system. HBP should be considered for those with unfavorable coronary sinus (CS) anatomy, and nonresponders to biventricular (BiV) pacing. HBP CRT may also help patients with the nonleft bundle branch block form of conduction delay and heart failure (HF). HBP CRT should be considered strongly in preventing right ventricular (RV) pacing-induced cardiomyopathy, especially after atrioventricular nodal ablation given the discrete nature of the block and the low likelihood of distal block...
March 6, 2018: Current Treatment Options in Cardiovascular Medicine
Antonio D'Onofrio, Salvatore Ivan Caico, Assunta Iuliano, Paolo Pieragnoli, Valter Bianchi, Daniela Orsida, Antonio Pani, Mario Pasqualini, Francesca Amadori, Ludovico Vasquez, Antonello Talarico, Chiara Minoia, Roberto Ospizio, Greta Merlotti, Maurizio Malacrida, Giuseppe Stabile
PURPOSE: Latency during left ventricle (LV) pacing has been suggested as a potential cause of ineffectual biventricular pacing. We assessed the incidence, predictors, and impact on outcome of increased LV latency in 274 patients undergoing cardiac resynchronization therapy (CRT). METHODS: On implantation, the latency interval was defined as the shortest stimulus-to-QRS onset interval in any lead of the 12-lead ECG. A stimulus-to-QRS onset interval ≥ 40 ms was used to define the presence of increased LV latency...
March 3, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Suneet Mittal, Dan L Musat, Michael H Hoskins, Julie B Prillinger, Gregory J Roberts, Yelena Nabutovsky, Faisal M Merchant
PURPOSE: The purpose of the current study is to characterize and quantify the impact of complete atrioventricular block (cAVB) on heart failure hospitalization (HFH) and healthcare utilization in pacemaker (PM) patients. METHODS: Patients ≥ 18 years implanted with a dual-chamber PM from April 2008 to March 2014 were selected from the MarketScan® Commercial and Medicare Supplemental claims databases. Patients with ≤ 1-year continuous MarketScan enrollment prior to and post-implant, and those with prior HF diagnosis were excluded...
February 28, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Laura R Bear, Peter R Huntjens, Richard Walton, Olivier Bernus, Ruben Coronel, Rémi Dubois
BACKGROUND: Poor identification of electrical dyssynchrony is postulated to be a major factor contributing to the low success rate for cardiac resynchronization therapy (CRT). OBJECTIVE: To evaluate body surface mapping and electrocardiographic imaging (ECGi) to detect electrical dyssynchrony noninvasively. METHODS: Langendorff-perfused pig hearts (n=11) were suspended in a human torso-shaped tank, with LBBB induced through ablation. Recordings were taken simultaneously from a 108-electrode epicardial sock and 128 electrodes embedded in the tank surface during sinus rhythm and ventricular pacing...
February 22, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Emmanouil Poulidakis, Constantina Aggeli, Konstantinos Kappos, Antonis S Manolis, Skevos Sideris, Konstantinos Gatzoulis, Evangelos Oikonomou, Dimitrios Tousoulis
Cardiac Resynchronization Therapy (CRT) is an established therapeutic option for the subset of patients with heart failure (HF), reduced ejection fraction (EF) and dyssynchrony evidenced by electrocardiography. Benefit from CRT has been proven in many clinical trials, yet a sizeable proportion of these patients with wide QRS do not respond to this intervention, despite the updated practice guidelines. Several echocardiographic indices, targeting mechanical rather than electrical dyssynchrony, have been suggested to address this issue, but research so far has not succeeded in providing a single and simple measurement with adequate sensitivity and specificity for identification of responders...
February 13, 2018: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
Avishag Laish-Farkash, Sharon Bruoha, Vladimir Khalameizer, Chaim Yosefy, Yoav Michowitz, Mahmoud Suleiman, Amos Katz
PURPOSE: Multisite cardiac resynchronization therapy (MSCRT) with dual-vein left ventricular (LV) pacing has theoretical advantages over conventional CRT in faster and more physiological LV activation. We aimed to define indications, feasibility, safety, acute, and long-term results of MSCRT. METHODS: All patients implanted with MSCRT during 2008-2014 in a single center were reviewed and analyzed. RESULTS: Thirty-nine patients (90% CRT-defibrillators, 64 ± 9 years, 85% male, 74% ischemic etiology) were included...
February 13, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Niraj Varma, David O'Donnell, Mohammed Bassiouny, Philippe Ritter, Carlo Pappone, Jan Mangual, Daniel Cantillon, Nima Badie, Bernard Thibault, Brian Wisnoskey
BACKGROUND: QRS narrowing following cardiac resynchronization therapy with biventricular (BiV) or left ventricular (LV) pacing is likely affected by patient-specific conduction characteristics (PR, qLV, LV-paced propagation interval), making a universal programming strategy likely ineffective. We tested these factors using a novel, device-based algorithm (SyncAV) that automatically adjusts paced atrioventricular delay (default or programmable offset) according to intrinsic atrioventricular conduction...
February 6, 2018: Journal of the American Heart Association
Fatima M Ezzeddine, Gopi Dandamudi
Long-term right ventricular apical pacing has been associated with detrimental effects, including an increased risk for heart failure, atrial fibrillation, and death. Most of these adverse effects result from ventricular dyssynchrony related to perturbed ventricular depolarization. In addition, biventricular pacing has limited benefits in patients with non-left bundle branch block and severely reduced ejection fraction. Consequently, alternative pacing strategies that mimic natural physiology are desired. Recently, permanent His bundle pacing has emerged as a true physiologic form of ventricular pacing that has been shown to be safe and feasible in clinical practice...
March 2018: Cardiac Electrophysiology Clinics
Pierre Socie, Fabien Squara, Marc Semichon, Olivier Thomas, Alain Khemache, Philippe Riccini, Pierre Squara, Vincent Algalarrondo, Ghassan Moubarak
BACKGROUND: Cardiac resynchronization therapy optimization can be pursued by left ventricular pacing vector selection, atrioventricular (AV) and interventricular (VV) delays optimization. The combination of these methods and its comparison with multipoint pacing (MPP) is scarcely studied. METHODS: Using non-invasive cardiac output (CO) measurement, the best of five left ventricular pacing vectors was determined, then AV and VV delays optimization was applied on top of the best vector...
February 6, 2018: Pacing and Clinical Electrophysiology: PACE
Antonio Berruezo, Markus Linhart, Angelo Auricchio, José Luis Zamorano, Pilar Santamaria, Roger Borràs, Felip Burgos, Josep Brugada
PURPOSE: Dual-chamber (DDD) pacing has been used for treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM). Due to inconclusive results in prior trials, current guidelines assign DDD pacing a class IIb indication in selected patients. Prior observations indicate that lack of clinical improvement may result from suboptimal effect of DDD pacing with non-physiological AV intervals due to fusion of intrinsic and paced QRS complex. METHODS: The Triple Chamber Pacing in Hypertrophic Obstructive Cardiomyopathy Patients (TRICHAMPION) trial is a prospective, randomized, single-blinded, multicenter study to investigate the benefit of atrial synchronous biventricular pacing (CRT-P) in highly symptomatic HOCM patients with severe left ventricular outflow tract (LVOT) obstruction who are not candidates for ablative therapies...
February 3, 2018: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Advay G Bhatt, Dan L Musat, Mark W Preminger, Tina Sichrovsky, Suneet Mittal
No abstract text is available yet for this article.
November 2017: HeartRhythm Case Reports
O Kittnar, L Riedlbauchová, J Tomis, M LoŽek, A Valeriánová, M Hrachovina, M Mlček, M Huptych, J Janoušek, L Lhotská
Cardiac resynchronization therapy (CRT) has proven efficacious in reducing or even eliminating cardiac dyssynchrony and thus improving heart failure symptoms. However, quantification of mechanical dyssynchrony is still difficult and identification of CRT candidates is currently based just on the morphology and width of the QRS complex. As standard 12-lead ECG brings only limited information about the pattern of ventricular activation, we aimed to study changes produced by different pacing modes on the body surface potential maps (BSPM)...
December 30, 2017: Physiological Research
Adam Graham, Rui Providencia, Shohreh Honarbakhsh, Neil Srinivasan, Vinit Sawhney, Ross Hunter, Pier Lambiase
INTRODUCTION: Cardiac resynchronization using a left ventricular (LV) epicardial lead placed in the coronary sinus is now routinely used in management of heart failure patients. LV endocardial pacing is an alternative when this is not feasible, with outcomes data sparse. OBJECTIVE: To review the available evidence on the efficacy and safety of endocardial LV pacing via meta-analysis. METHODS: EMBASE, MEDLINE and COCHRANE databases with the search term "endocardial biventricular pacing" or "endocardial cardiac resynchronization" or "left ventricular endocardial" or "endocardial left ventricular"...
January 18, 2018: Pacing and Clinical Electrophysiology: PACE
Alan J Bank, Ryan M Gage, Antonia E Curtin, Kevin V Burns, Jeffrey M Gillberg, Subham Ghosh
BACKGROUND: Electrical synchronization is likely improved by cardiac resynchronization therapy (CRT), but is difficult to quantify with 12-lead ECG. We aimed to quantify changes in electrical synchrony and potential for optimization with CRT using a body-surface activation mapping (BSAM) system. METHODS: Standard deviation of activation times (SDAT) was calculated in 94 patients using BSAM at baseline CRT (CRTbl), native, and different CRT configurations. RESULTS: SDAT decreased 20% from native to CRTbl (p<0...
December 6, 2017: Journal of Electrocardiology
Danielle E Harake, Kevin M Shannon, Jamil A Aboulhosn, Jeremy P Moore
INTRODUCTION: The bidirectional Glenn operation for congenital heart disease produces anatomical constraints to conventional transvenous pacemaker implantation. An iliac approach, although not previously described in this population, is potentially a preferable alternative to a thoracotomy for epicardial pacing. METHODS AND RESULTS: A single-center retrospective review was performed for all patients that underwent transvenous pacemaker implantation following the bidirectional Glenn operation with partial biventricular repair...
December 14, 2017: Journal of Cardiovascular Electrophysiology
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