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Biventricular Pacing

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https://www.readbyqxmd.com/read/28725029/prominent-differences-in-left-ventricular-performance-and-myocardial-properties-between-right-ventricular-and-left-ventricular-based-pacing-modes-in-rats
#1
Wesam Mulla, Sharon Etzion, Sigal Elyagon, Roni Gillis, Michael Murninkas, Yuval Konstantino, Ingra Mannhardt, Thomas Eschenhagen, Noah Liel-Cohen, Yoram Etzion
Biventricular pacing is an important modality to improve left ventricular (LV) synchronization and long-term function. However, the biological effects of this treatment are far from being elucidated and existing animal models are limited and demanding. Recently, we introduced an implanted device for double-site epicardial pacing in rats and echocardiographically demonstrated favorable effects of LV and biventricular (LV-based) pacing modes typically observed in humans. Here, this new animal model was further characterized...
July 19, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28695377/ventricular-dyssynchrony-assessment-using-ultra-high-frequency-ecg-technique
#2
Pavel Jurak, Josef Halamek, Jaroslav Meluzin, Filip Plesinger, Tereza Postranecka, Jolana Lipoldova, Miroslav Novak, Vlastimil Vondra, Ivo Viscor, Ladislav Soukup, Petr Klimes, Petr Vesely, Josef Sumbera, Karel Zeman, Roshini S Asirvatham, Jason Tri, Samuel J Asirvatham, Pavel Leinveber
PURPOSE: The aim of this proof-of-concept study is to introduce new high-dynamic ECG technique with potential to detect temporal-spatial distribution of ventricular electrical depolarization and to assess the level of ventricular dyssynchrony. METHODS: 5-kHz 12-lead ECG data was collected. The amplitude envelopes of the QRS were computed in an ultra-high frequency band of 500-1000 Hz and were averaged (UHFQRS). UHFQRS V lead maps were compiled, and numerical descriptor identifying ventricular dyssynchrony (UHFDYS) was detected...
July 10, 2017: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
https://www.readbyqxmd.com/read/28680621/development-of-ventricular-fibrillation-after-implantation-of-a-biventricular-implantable-cardioverter-defibrillator-what-is-the-mechanism
#3
Diego Chemello, Fernando Pivatto Júnior, Maurício Pimentel, Leandro Zimerman
Syncopal spells in heart failure patient with cardiovascular implantable electronic devices (CIED) require multiple assessments. T-wave oversensing is a well-described phenomenon that remains significant in modern implantable cardioverter defibrillators (ICD) systems. It can lead to inappropriate therapies and loss of biventricular pacing in those with cardiac resynchronization devices. Strategies to overcome this problem are important.
July 2017: Clinical Case Reports
https://www.readbyqxmd.com/read/28653458/left-ventricular-only-pacing-in-heart-failure-patients-with-normal-atrioventricular-conduction-improves-global-function-and-left-ventricular-regional-mechanics-compared-with-biventricular-pacing-an-adaptive-cardiac-resynchronization-therapy-sub-study
#4
Kevin V Burns, Ryan M Gage, Antonia E Curtin, John Gorcsan, Alan J Bank
AIMS: Right ventricular (RV) pacing can impair left ventricular (LV) function. When timed with native RV activation, LV-only pacing may cause greater improvements in LV function than biventricular pacing. This study compared the chronic effects of cardiac resynchronization therapy (CRT) on LV mechanics between biventricular pacing and LV-only pacing in patients with normal atrioventricular (AV) conduction. METHODS AND RESULTS: The Adaptive CRT (aCRT) algorithm provides LV-only pacing timed with native RV activation when the AV interval is normal (≤200 ms during sinus rhythm)...
June 26, 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28653309/refined-heart-failure-detection-algorithm-for-improved-clinical-reliability-of-optivol-alerts-in-crt-d-recipients
#5
Mate Vamos, Noemi Nyolczas, Zsolt Bari, Peter Bogyi, Balazs Muk, Barna Szabo, Bettina Ancsin, Robert G Kiss, Gabor Z Duray
BACKGROUND: The reliability of intrathoracic impedance monitoring for prediction of heart failure (HF) by implantable cardiac devices is controversial. Despite using additional device-based parameters described in the PARTNERS HF study, such as new onset of arrhythmias, abnormal autonomics, low biventricular pacing rate or patient activity level, the predictive power of device diagnostic algorithm is still in doubt. The objective of this study was to compare the device diagnostic algorithm described in the PARTNERS HF study to a newly developed algorithm applying refined diagnostic criteria...
June 27, 2017: Cardiology Journal
https://www.readbyqxmd.com/read/28641799/the-continued-search-for-physiological%C3%A2-pacing-where-are-we-now
#6
REVIEW
Pugazhendhi Vijayaraman, Pierre Bordachar, Kenneth A Ellenbogen
Cardiac pacing is an effective treatment for patients with bradycardia due to sinus node dysfunction or atrioventricular block. Despite decades of technological advances, the optimal ventricular pacing site to mimic normal human ventricular physiology and best hemodynamic response remains elusive. Beginning with atrial synchronous right ventricular (RV) apical pacing, the search has continued through alternate RV pacing sites, minimizing RV pacing, biventricular pacing, left ventricular (LV) pacing, and His-bundle pacing...
June 27, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28630373/incidence-and-time-course-for-developing-heart-failure-with-high-burden-right-ventricular-pacing
#7
Faisal M Merchant, Michael H Hoskins, Dan L Musat, Julie B Prillinger, Gregory J Roberts, Yelena Nabutovsky, Suneet Mittal
BACKGROUND: Although right ventricular pacing can contribute to cardiomyopathy, the impact of complete atrioventricular block (cAVB) on heart failure (HF) development in pacemaker patients has not been well characterized. We evaluated the incidence and time course for developing HF after pacemaker implantation for cAVB. METHODS AND RESULTS: A MarketScan database identified patients undergoing dual-chamber pacemaker implantation from 2008 to 2014. Patients with cAVB were identified by an atrioventricular node ablation or diagnosis of third-degree AVB...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28603001/low-lateral-thoracic-site-for-cardiac-implantable-electronic-device-implantation-a-viable-alternative-in-patients-with-limited-access-options-after-infected-device-extraction
#8
Jackson J Liang, Robert D Schaller, Danesh S Modi, Andres Enriquez, Gregory E Supple, Joshua M Cooper
BACKGROUND: Device reimplantation after extraction because of cardiac implantable electronic device (CIED) infection in pacemaker-dependent patients can be challenging in individuals with limited access options. OBJECTIVE: The purpose of this study was to describe a straightforward, low lateral thoracic implantation technique for patients with a patent axillary vein but unavailable bilateral pectoral sites. METHODS: Nine pacemaker-dependent patients (mean age 70 ± 13 years, 7 male) who underwent CIED extraction and low lateral thoracic reimplantation in whom bilateral pectoral sites were unavailable were included in the study...
June 8, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28543106/the-concept-of-triple-wavefront-fusion-during-biventricular-pacing-using-the-egm-to-produce-the-best-acute-hemodynamic-improvement-in-crt
#9
Iris A H Ter Horst, Margot D Bogaard, Anton E Tuinenburg, Thomas P Mast, Teun P de Boer, Pieter A F M Doevendans, Mathias Meine
BACKGROUND: Previous reports suggest that biventricular pacing (BiVp) fused with intrinsic conduction (BiVp-fusion, triple wavefront fusion) is associated with improved resynchronization compared to pure-BiVp in cardiac resynchronization therapy (CRT). This study aimed to assess the association between acute hemodynamic benefit of CRT and signs of BiVp-fusion by using a novel electrogram (EGM)-based method. METHODS: In 17 patients undergoing CRT implantation, 28 combinations of atrioventricular (AV) and interventricular (VV) delays were applied while invasively measuring acute hemodynamic response based on maximum rate of left ventricular (LV) pressure rise (LV dP/dtmax ) to assess optimal BiVp settings...
May 23, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28517367/rationale-and-design-of-a-randomized-trial-to-assess-the-safety-and-efficacy-of-multipoint-pacing-mpp-in-cardiac-resynchronization-therapy-the-mpp-trial
#10
Gery Tomassoni, James Baker, Raffaele Corbisiero, Charles Love, David Martin, Robert Sheppard, Seth J Worley, Kwangdeok Lee, Imran Niazi
BACKGROUND: Although the majority of Class III congestive heart failure (HF) patients treated with cardiac resynchronization therapy (CRT) show a clinical benefit, up to 40% of patients do not respond to CRT. This paper reports the design of the MultiPoint Pacing (MPP) trial, a prospective, randomized, double-blind, controlled study to evaluate the safety and efficacy of CRT using MPP compared to standard biventricular (Bi-V) pacing. METHODS: A maximum of 506 patients with a standard CRT-D indication will be enrolled at up to 50 US centers...
May 18, 2017: Annals of Noninvasive Electrocardiology
https://www.readbyqxmd.com/read/28515003/reverse-atrial-electrical-remodeling-induced-by-cardiac-resynchronization-therapy
#11
Bryce Alexander, Fariha Sadiq, Kousha Azimi, Benedict Glover, Pavel Antiperovitch, Wilma M Hopman, Zardasht Jaff, Adrian Baranchuk
PURPOSE: Cardiac resynchronization therapy (CRT) has been shown to improve left atrial function; however the effect on reverse electrical remodeling has been poorly evaluated. We hypothesized that CRT might induce reverse atrial electrical remodeling manifesting in the surface ECG as a shortening in P-wave duration. METHODS: Patients with CRT and more than 92% biventricular pacing at minimum follow-up of 1 year were included in the analysis. Those with prior history of atrial fibrillation (AF) were excluded...
April 28, 2017: Journal of Electrocardiology
https://www.readbyqxmd.com/read/28512720/pacing-induced-ventricular-dysfunction-in-a-child-improvement-with-reduction-in-paced-rate
#12
Shilpi Garg, Seshadri Balaji
Right ventricular (RV) pacing can be associated with impairment of left ventricular (LV) function due to electrical dyssynchrony and myocardial remodeling (Janousek et al. in J Cardiovasc Electrophysiol 15:470-474, 2004). RV-pacing induced ventricular dysfunction is reversible by techniques such as biventricular pacing and LV apical or LV free wall pacing or turning the pacemaker off which have all been shown to restore synchrony and improve left ventricular function (Janousek et al. in J Cardiovasc Electrophysiol 15:470-474, 2004; Geldorp et al...
May 17, 2017: Pediatric Cardiology
https://www.readbyqxmd.com/read/28502795/multi-scale-tailor-made-heart-simulation-can-predict-the-effect-of-cardiac-resynchronization-therapy
#13
Jun-Ichi Okada, Takumi Washio, Machiko Nakagawa, Masahiro Watanabe, Yoshimasa Kadooka, Taro Kariya, Hiroshi Yamashita, Yoko Yamada, Shin-Ichi Momomura, Ryozo Nagai, Toshiaki Hisada, Seiryo Sugiura
BACKGROUND: The currently proposed criteria for identifying patients who would benefit from cardiac resynchronization therapy (CRT) still need to be optimized. A multi-scale heart simulation capable of reproducing the electrophysiology and mechanics of a beating heart may help resolve this problem. The objective of this retrospective study was to test the capability of patient-specific simulation models to reproduce the response to CRT by applying the latest multi-scale heart simulation technology...
May 11, 2017: Journal of Molecular and Cellular Cardiology
https://www.readbyqxmd.com/read/28491086/left-univentricular-pacing-for-cardiac-resynchronization-therapy-using-rate-adaptive-atrioventricular-delay
#14
Li-Jin Pu, Yu Wang, Lu-Lu Zhao, Tao Guo, Shu-Min Li, Bao-Tong Hua, Ping Yang, Jun Yang, Yan-Zhou Lu, Liu-Qing Yang, Ling Zhao, Hai-Yun Luo
OBJECTIVE: To evaluate left univentricular (LUV) pacing for cardiac resynchronization therapy (CRT) using a rate-adaptive atrioventricular delay (RAAVD) algorithm to track physiological atrioventricular delay (AVD). METHODS: A total of 72 patients with congestive heart failure (CHF) were randomized to RAAVD LUV pacing versus standard biventricular (BiV) pacing in a 1: 1 ratio. Echocardiography was used to optimize AVD for both groups. The effects of sequential BiV pacing and LUV pacing with optimized A-V (right atrio-LV) delay using an RAAVD algorithm were compared...
February 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28489502/advances-in-cardiac-pacing-and-defibrillation
#15
REVIEW
Kristin Ellison, Parikshit S Sharma, Richard Trohman
There have been many evolutionary milestones in cardiac implantable electronic device (CIED) therapy over the past few decades. These advancements have created new  challenges. Right ventricular pacing was the original (late 1950s) breakthrough, however the risk of pacing induced dyssynchrony has become evident. Biventricular pacing provided a viable way to mitigate dyssynchrony, but only benefits certain patients (primarily left bundle branch block and QRS duration ≥150 ms with depressed left ventricular (LV) function)...
June 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28467647/prediction-of-optimal-cardiac-resynchronization-by-vectors-extracted-from-electrograms-in-dyssynchronous-canine-hearts
#16
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/28460773/the-development-of-pacing-induced-ventricular-dysfunction-is-influenced-by-the-underlying-structural-heart-defect-in-children-with-congenital-heart-disease
#17
Seshadri Balaji, Narayanswami Sreeram
BACKGROUND: Right ventricular pacing can cause pacing-induced ventricular dysfunction (PIVD) correctable with biventricular pacing (BiVP). Factors associated with PIVD are poorly understood. METHODS: We reviewed children receiving epicardial dual-chamber pacemakers for complete heart block (CHB) after congenital heart disease (CHD) surgery. PIVD was defined as% fractional shortening <15% improving after BiVP. RESULTS: Between 2005 and 2014, 47 children <2years developed CHB after CHD surgery...
March 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28449772/cardiac-resynchronization-therapy-with-wireless-left-ventricular-endocardial-pacing-the%C3%A2-select-lv-study
#18
MULTICENTER STUDY
Vivek Y Reddy, Marc A Miller, Petr Neuzil, Peter Søgaard, Christian Butter, Martin Seifert, Peter Paul Delnoy, Lieselot van Erven, Martin Schalji, Lucas V A Boersma, Sam Riahi
BACKGROUND: A total of 30% to 40% of patients with congestive heart failure eligible for cardiac resynchronization therapy (CRT) either do not respond to conventional CRT or remain untreated due to an inability or impediment to coronary sinus (CS) lead implantation. The WiSE-CRT system (EBR Systems, Sunnyvale, California) was developed to address this at-risk patient population by performing biventricular pacing via a wireless left ventricular (LV) endocardial pacing electrode. OBJECTIVES: The SELECT-LV (Safety and Performance of Electrodes implanted in the Left Ventricle) study is a prospective multicenter non-randomized trial assessing the safety and performance of the WiSE-CRT system...
May 2, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28430960/triple-site-pacing-for-cardiac-resynchronization-in-permanent-atrial-fibrillation-follow-up-results-from-a-prospective-observational-study
#19
Pedro Marques, Miguel Nobre Menezes, Gustavo Lima da Silva, Tatiana Guimarães, Ana Bernardes, Nuno Cortez-Dias, Luis Carpinteiro, João de Sousa, Fausto J Pinto
Aims: Cardiac Resynchronization Therapy (CRT) is associated with a particularly high non-response rate in patients with atrial fibrillation (AF). We aimed to assess the effectiveness of triple-site (Tri-V) pacing CRT in this population. Methods and results: Prospective observational study of patients with permanent AF who underwent CRT implantation with an additional right ventricle lead in the outflow tract septal wall. After implantation, programming mode (Tri-V or biventricular pacing) was selected based on cardiac output determination...
April 19, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28430911/a-devices-game-of-thrones-cardiac-resynchronization-therapy-vs-pacemaker
#20
Sara Moura-Ferreira, Helena Gonçalves, Marco Oliveira, João Primo, Paulo Fonseca, José Ribeiro, Elisabeth Santos, Nuno Pelicano, Dinis Martins, Vasco Gama
Aims: Oversensing can interfere with biventricular pacing. Cardiac Resynchronization Therapy (CRT) output inhibition due to automatic brady mode change from a sensing to a pacing mode of a previously implanted pacemaker as it reached battery capacity depleted indicator has not been previously published in the medical literature. Methods and Results: We report the first case of CRT output inhibition in a pacemaker dependent patient due to electrical stimuli from a previously right-sided implanted pacemaker, after unaware reversion of OVO mode (O = no chambers paced; V = ventricular sensing; O = no response to sensing) to backup VVI (V = ventricular pacing; V = ventricular sensing; I = inhibitory response to sensing) when it reached the elective replacement interval...
April 18, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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