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Biventricular Pacing

Federico Ferrando-Castagnetto, Roberto Ricca-Mallada, Alejandro Vidal, Fabián Martínez, Rodolfo Ferrando
Pacemaker stimulation is associated with unpredictable severe cardiac events. We evaluated left ventricular mechanical dyssynchrony (LVMD) during prolonged septal right ventricular pacing. We performed 99mTc-MIBI gated-SPECT and phase analysis in 6 patients with pacemakers implanted at least one year before scintigraphy due to advanced atrioventricular block. Using V-Sync of Emory Cardiac Toolbox we obtained phase bandwidth (PBW) and standard deviation (PSD) from rest phase histogram. Clinical variables, QRS duration, rate and mode of pacing in septal right ventricle wall, chamber diameters, presence and extension of myocardial scar and ischemia and rest LVEF were recorded...
2016: Medicina
Mark K Friedberg, Steven M Schwartz, Hargen Zhang, Christine Chiu-Man, Cedric Manlhiot, Maria V Ilina, Glen Van Arsdell, Joel A Kirsh, Brian W McCrindle, Elizabeth A Stephenson
BACKGROUND: It is unknown whether continuous cardiac resynchronization therapy (CRT) can lead to sustained improvement in hemodynamics after surgery for congenital heart disease (CHD). OBJECTIVE: We investigated whether CRT improves cardiac index (CI) and blood pressure in infants after biventricular repair of CHD. METHODS: We randomized infants < 4-months of age after biventricular CHD surgery to standard care or standard care plus CRT for 48-hours or until extubation if sooner...
September 26, 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
John M Fontaine, Ashwani Gupta, Sona M Franklin, Christina U Kang, Latrisha A Whigham
No abstract text is available yet for this article.
September 2016: Journal of Electrocardiology
Marcus Ståhlberg, Frieder Braunschweig, Fredrik Gadler, Lars Mortensen, Lars H Lund, Cecilia Linde
Heart failure (HF) is considered as an epidemic and affects 2% of the population in the Western world. About 15-30% of patients with HF and reduced ejection fraction (HFrEF) also have prolonged QRS duration on the surface ECG, most commonly as a result of left-bundle branch block (LBBB). Increased QRS duration is a marker of a dyssynchronous activation, and subsequent contraction, pattern in the left ventricle (LV). When dyssynchrony is superimposed on the failing heart it further reduced systolic function and ultimately worsens outcome...
August 30, 2016: Scandinavian Cardiovascular Journal: SCJ
Hiroko Beck, Anne B Curtis
The use of cardiac resynchronization therapy (CRT) is well accepted as an important option for the treatment of patients with systolic heart failure and prolonged QRS duration. CRT for patients with narrow QRS complexes is reserved for patients who are undergoing implantation of new or replacement pacemakers or implantable cardioverter defibrillators with an anticipated significant requirement for ventricular pacing. The Biventricular versus Right Ventricular Pacing in Heart Failure Patients with Atrioventricular Block (BLOCK HF) Trial examined the role of CRT in heart failure patients with atrioventricular block and demonstrated significantly better outcomes with CRT compared to right ventricular pacing...
August 23, 2016: Current Heart Failure Reports
Serkan Cay, Ozcan Ozeke, Firat Ozcan, Dursun Aras, Serkan Topaloglu
No abstract text is available yet for this article.
November 15, 2016: International Journal of Cardiology
Brian Olshansky, Mark Richards, Arjun Sharma, Nicholas Wold, Paul Jones, David Perschbacher, Bruce L Wilkoff
BACKGROUND: Rate-responsive pacing (DDDR) versus nonrate-responsive pacing (DDD) has shown no survival benefit for patients undergoing cardiac resynchronization therapy defibrillator (CRT-D) implants. The heart rate score (HRSc), an indicator of heart rate variation, may predict survival. We hypothesized that high-risk HRSc CRT-D patients will have improved survival with DDDR versus DDD alone. METHODS AND RESULTS: All CRT-D patients in LATITUDE remote monitoring (2006-2011), programmed DDD, had HRSc calculated at first data upload after implant (median 1...
August 2016: Circulation. Arrhythmia and Electrophysiology
Barbara Bellmann, Bogdan G Muntean, Tina Lin, Christopher Gemein, Kathrin Schmitz, Patrick Schauerte
OBJECTIVES: Right ventricular (RV) pacing induces a left bundle branch block pattern on ECG and may promote heart failure. Patients with dual chamber pacemakers (DCPs) who present with progressive reduction in left ventricular ejection fraction (LVEF) secondary to RV pacing are candidates for cardiac resynchronization therapy (CRT). This study analyzes whether upgrading DCP to CRT with the additional implantation of a left ventricular (LV) lead improves LV function in patients with reduced LVEF following DCP implantation...
September 2016: Anatolian Journal of Cardiology
Soumen Devidutta, Chennapragada Sridevi, Calambur Narasimhan
Cardiac resynchronization therapy device (CRT-P and CRT-D) implantation has increased tremendously with increasing operator experience, eligible patients and expansion of indications. Refinements in devices and algorithms now aid physicians to improve biventricular pacing and optimize CRT. We report a case in which an interesting device program was used to achieve biventricular pacing after repeated dislodgement of the atrial lead in a patient implanted with CRT-D.
January 2016: Indian Pacing and Electrophysiology Journal
Micaela Ebert, Nikolaus Jander, Jan Minners, Thomas Blum, Michael Doering, Andreas Bollmann, Gerhard Hindricks, Thomas Arentz, Dietrich Kalusche, Sergio Richter
BACKGROUND: There is limited evidence of long-term impact of right ventricular pacing on left ventricular (LV) systolic function in pacemaker recipients with preserved LV ejection fraction (LVEF). The objective of the study was to evaluate the outcome and echocardiographic course of baseline preserved LVEF in a large cohort of pacemaker recipients with respect to pacing indication and degree of right ventricular pacing. METHODS AND RESULTS: We enrolled 991 patients (73±10 years, 54% male) with baseline normal (>55%) LVEF (n=791) or mildly reduced (41-55%) LVEF (n=200) who had paired echocardiographic data on LV systolic function recorded at implantation and last follow-up...
July 2016: Journal of the American Heart Association
Salah A M Said, Rogier Nijhuis, Anita Derks, Herman Droste
BACKGROUND Cardiac resynchronization therapy (CRT) has been demonstrated to reduce morbidity and mortality in patients with advanced, drug-refractory heart failure. Procedure-related mortality is less than 1% in larger studies. Approximately10% of CRT patients have to undergo surgical revision because of infections, dislocations, or unacceptable electrical behavior manifested as high threshold, unstable sensing, or unwanted phrenic nerve stimulation. CASE REPORT A 70-year-old man with symptomatic congestive heart failure underwent implantation of a biventricular pacemaker on the left anterior chest wall in 2003 and pulse generator exchange in August 2009...
2016: American Journal of Case Reports
Giuseppe Coppola, Gianfranco Ciaramitaro, Giuseppe Stabile, Antonio DOnofrio, Pietro Palmisano, Patrizia Carità, Giosuè Mascioli, Domenico Pecora, Antonio De Simone, Massimiliano Marini, Antonio Rapacciuolo, Gianluca Savarese, Giampiero Maglia, Patrizia Pepi, Luigi Padeletti, Attilio Pierantozzi, Giuseppe Arena, Tiziana Giovannini, Salvatore Ivan Caico, Cinzia Nugara, Laura Ajello, Maurizio Malacrida, Egle Corrado
BACKGROUND: Several studies have investigated the association between native QRS duration (QRSd) or QRS narrowing and response to biventricular pacing. However, their results have been conflicting. The aim of our study was to determine the association between the relative change in QRS narrowing index (QI) and clinical outcome and prognosis in patients who undergo cardiac resynchronization therapy (CRT) implantation. METHODS AND RESULTS: We included 311 patients in whom a CRT device was implanted in accordance with current guidelines for CRT...
October 15, 2016: International Journal of Cardiology
B Herweg, M B Marcus, S S Barold
The diagnosis of myocardial infarction (MI) in the presence of left bundle branch block (LBBB) or during ventricular pacing (VP) is challenging because of inherent changes in the sequence of ventricular depolarization and repolarization associated with both conditions. Although LBBB and right ventricular (RV) pacing may both produce abnormalities in the ECG, it is often possible to diagnose an acute MI (AMI) or an old MI based on selected morphologic changes. Primary ST-segment changes scoring 3 points or greater according to the Sgarbossa criteria are highly predictive of an AMI in patients with LBBB or RV pacing...
September 2016: Herzschrittmachertherapie & Elektrophysiologie
Michał Mazurek, Ewa Jędrzejczyk-Patej, Radosław Lenarczyk, Agnieszka Liberska, Katarzyna Przybylska-Siedlecka, Monika Kozieł, Stanisław Morawski, Tomasz Podolecki, Jacek Kowalczyk, Patrycja Pruszkowska, Sławomir Pluta, Adam Sokal, Oskar Kowalski, Zbigniew Kalarus
BACKGROUND: Incidence and clinical significance of transient, daily fluctuations of biventricular pacing percentage (CRT%) remain unknown. We assessed the value of daily remote monitoring in identifying prognostically critical burden of low CRT%. METHODS AND RESULTS: Prospective, single-centre registry encompassed 304 consecutive heart failure patients with cardiac resynchronization therapy defibrillators (CRT-D). Patients with 24-h episodes of CRT% loss<95% were assigned to quartiles depending on cumulative time spent in low CRT%: quartile 1 (1-8days), 2 (9-20days), 3 (21-60days) and quartile 4 (>60days)...
October 15, 2016: International Journal of Cardiology
Aya Miyazaki, Heima Sakaguchi, Kanae Noritake, Yosuke Hayama, Jun Negishi, Koji Kagisaki, Kenji Yasuda, Hajime Ichikawa, Hideo Ohuchi
We describe of a unique pattern of cardiac dyssynchrony in a patient with a biventricular physiology and systemic right ventricle (RV): the interventricular dyssynchrony due to a contraction delay between the left ventricle and RV. In the present case, the cineangiography and intracardiac electrocardiography of the RV did not reveal intraventricular dyssynchrony of the RV, but revealed interventricular dyssynchrony. In addition, the pressure curves of the ventricles exhibited time phase differences between the two ventricles...
July 6, 2016: Heart and Vessels
Aditya V S Ponnaluri, Luigi E Perotti, Michael Liu, Zhilin Qu, James N Weiss, Daniel B Ennis, William S Klug, Alan Garfinkel
Heart failure is a leading cause of death, yet its underlying electrophysiological (EP) mechanisms are not well understood. In this study, we use a multiscale approach to analyze a model of heart failure and connect its results to features of the electrocardiogram (ECG). The heart failure model is derived by modifying a previously validated electrophysiology model for a healthy rabbit heart. Specifically, in accordance with the heart failure literature, we modified the cell EP by changing both membrane currents and calcium handling...
June 2016: PLoS Computational Biology
Luka Lipar, Komandoor Srivathsan, Luis Roberto Scott
BACKGROUND: Cardiac resynchronization therapy (CRT) is considered as a standard adjunct therapy in symptomatic patients with congestive heart failure (CHF) who have a prolonged QRS. There is an increasing number of patients who do not receive de novo CRT devices but are upgraded from right ventricular (RV) pacing to biventricular stimulation. We wanted to evaluate the benefit of CRT in patients with chronic RV pacing in comparison to previously non-paced heart failure patients. METHODS: One hundred and sixty-five patients who had their device newly implanted (group I) and 116 who were upgraded from previously implanted RV pacing systems (group II) at Mayo Clinic Hospital were retrospectively analyzed...
September 15, 2016: International Journal of Cardiology
Zhong Chen, Ben Hanson, Manav Sohal, Eva Sammut, Tom Jackson, Nicholas Child, Simon Claridge, Jonathan Behar, Steve Niederer, Jaswinder Gill, Gerald Carr-White, Reza Razavi, C Aldo Rinaldi, Peter Taggart
BACKGROUND: The high risk of ventricular arrhythmias in patients with heart failure remains despite the benefit of cardiac resynchronization therapy (CRT). An electromechanical interaction between regional myocardial strain patterns and the electrophysiological substrate is thought to be important. OBJECTIVE: We investigated the in vivo relation between left ventricular activation recovery interval (ARI), as a surrogate measure of action potential duration (APD), and local myocardial strain patterns in responders and nonresponders to CRT...
September 2016: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Michael R Bristow, Leslie A Saxon, Arthur M Feldman, Chaoqun Mei, Susan A Anderson, David L DeMets
COMPANION (Comparison of Medical Therapy, Pacing and Defibrillation in Heart Failure), the first cardiac resynchronization therapy (CRT)-heart failure mortality and morbidity controlled clinical trial planned, conducted, and reported, was a randomized, 3-arm study that compared CRT delivered by a biventricular pacemaker (CRT-P) or a CRT defibrillator device (CRT-D) with optimal pharmacological therapy alone. The patient population had advanced chronic heart failure with QRS interval prolongation ≥120 ms and reduced left ventricular ejection fraction (heart failure with reduced ejection fraction)...
July 2016: JACC. Heart Failure
Shi-Min Yuan, Gulimila Humuruola
Fetal cardiac interventions for congenital heart diseases may alleviate heart dysfunction, prevent them evolving into hypoplastic left heart syndrome, achieve biventricular outcome and improve fetal survival. Candidates for clinical fetal cardiac interventions are now restricted to cases of critical aortic valve stenosis with evolving hypoplastic left heart syndrome, pulmonary atresia with an intact ventricular septum and evolving hypoplastic right heart syndrome, and hypoplastic left heart syndrome with an intact or highly restrictive atrial septum as well as fetal heart block...
2016: Postępy W Kardiologii Interwencyjnej, Advances in Interventional Cardiology
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