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Cardiac Resynchronization Therapy

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https://www.readbyqxmd.com/read/28724879/infectious-complications-in-patients-with-cardiac-implantable-electronic-devices-risk-factors-prevention-and-prognosis
#1
Anna Polewczyk, Wojciech Jacheć, Aneta Maria Polewczyk, Andrzej Tomasik, Marianna Janion, Andrzej Kutarski
INTRODUCTION    Cardiac device infections (CDI) are still a significant problem. The knowledge of risk factors for CDI is crucial both for preventing infections and reducing mortality. OBJECTIVES    The assesment of the risk factors and long term survival of patients with CDI. PATIENTS AND METHODS    The clinical data of 1837 patients (40.9% CDI) undergoing transvenous leads extraction (TLE) at a single institution from 2006 to 2015 was analyzed. We compared the clinical and procedure-related factors for all types of CDI: isolated pocket infection (IPI), isolated lead-related infective endocarditis (ILRIE) and PI+LRIE...
July 19, 2017: Polish Archives of Internal Medicine
https://www.readbyqxmd.com/read/28718277/clinical-implications-of-long-term-ecg-monitoring-from-loop-recorder-to-devices-remote-control
#2
Andrea DI Cori, Raffaele DE Lucia
Long term ECG monitoring has become nowadays an indispensable technology for prevention, management and treatment of many cardiac issues. Today long term ECG monitoring is achievable through loop recorders (LR) and cardiac devices (CIED) like pacemaker (PM), implantable cardioverter-defibrillators (ICDs) and cardiac resynchronization therapy device-defibrillators (CRT- Ds), all of which associated with remote monitoring (RM). Targeted long term ECG monitoring Patients who have recurrent non documented episodes of palpitations, unexplained episodes of syncope, cryptogenic stroke or patients with a cardiomiopathy needing a risk stratification, may benefit from long term ECG monitoring...
July 18, 2017: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/28714039/current-role-of-echocardiography-in-cardiac-resynchronization-therapy
#3
REVIEW
Donato Mele, Matteo Bertini, Michele Malagù, Marianna Nardozza, Roberto Ferrari
Cardiac resynchronization therapy (CRT) is an established treatment for patients with heart failure and left ventricular systolic dysfunction. Patients are usually assessed by echocardiography, which provides a number of anatomical and functional information used for cardiac dyssynchrony assessment, prognostic stratification, identification of the optimal site of pacing in the left ventricle, optimization of the CRT device, and patient follow-up. Compared to other cardiac imaging techniques, echocardiography has the advantage to be non-invasive, repeatable, and safe, without exposure to ionizing radiation or nefrotoxic contrast...
July 17, 2017: Heart Failure Reviews
https://www.readbyqxmd.com/read/28708290/rationale-and-design-of-the-adaptresponse-trial-a-prospective-randomized-study-of-cardiac-resynchronization-therapy-with-preferential-adaptive-left-ventricular-only-pacing
#4
Gerasimos Filippatos, David Birnie, Michael R Gold, Bart Gerritse, Ahmad Hersi, Sandra Jacobs, Kengo Kusano, Christophe Leclercq, Wilfried Mullens, Bruce L Wilkoff
The AdaptResponse trial is designed to test the hypothesis that preferential adaptive left ventricular-only pacing with the AdaptivCRT(®) algorithm reduces the incidence of the combined endpoint of all-cause mortality and intervention for heart failure (HF) decompensation, compared with conventional cardiac resynchronization therapy (CRT), among patients with a CRT indication, left bundle branch block (LBBB) and normal atrioventricular (AV) conduction. The AdaptResponse study is a prospective, randomized, controlled, single-blinded, multicentre, clinical trial (ClinicalTrials...
July 2017: European Journal of Heart Failure
https://www.readbyqxmd.com/read/28701672/the-shortest-qrs-duration-of-an-electrocardiogram-might-be-an-optimal-electrocardiographic-predictor-for-response-to-cardiac-resynchronization-therapy
#5
Jan-Yow Chen, Kuo-Hung Lin, Kuan-Cheng Chang, Che-Yi Chou
QRS duration has been associated with the response to cardiac resynchronization therapy (CRT). However, the methods for defining QRS duration to predict the outcome of CRT have discrepancies in previous reports. The aim of this study was to determine an optimal measurement of QRS duration to predict the response to CRT.Sixty-one patients who received CRT were analyzed. All patients had class III-IV heart failure, left ventricular ejection fraction not more than 35%, and complete left bundle branch block. The shortest, longest, and average QRS durations from the 12 leads of each electrocardiogram (ECG) were measured...
July 13, 2017: International Heart Journal
https://www.readbyqxmd.com/read/28699408/bridging-the-gap-between-heart-failure-and-the-device-clinic
#6
John Rickard, Bruce L Wilkoff
While cardiac resynchronization therapy (CRT) is a mainstay in the management of selected patients with chronic systolic dysfunction, many patients are noted to experience less than expected or no benefit at all from the therapy. Multidisciplinary care has been shown to provide benefit in follow up for patients receiving CRT devices. Areas Covered: This review will focus on the apparent reasons behind less than optimal outcomes following CRT as well as multidisciplinary approaches to treating patients with CRT devices...
July 12, 2017: Expert Review of Medical Devices
https://www.readbyqxmd.com/read/28691201/combined-myocardial-deformation-to-predict-cardiac-resynchronization-therapy-response-in-non-ischemic-cardiomyopathy
#7
Ning Yang, Zhao-Guang Liang, Zhao-Jun Wang, Hui Liu, Chao Chi, Yan-Feng Tian, Shu-Han Qi, Bi-Yu Wang, Wei Han
BACKGROUND: 20-30% of patients do not benefit from CRT when the established selection criteria were applied. We hypothesized that a combined assessment of mechanical dyssynchrony, myocardial deformation and diastolic function would identify patients who would benefit most from CRT. METHOD: In 36 CRT patients, clinical evaluation and echocardiography were performed before and after CRT. Patients were classified into 3 subgroups according to their amount of response: echocardiographic responders, clinical responders, and nonresponders...
July 10, 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/28688704/long-term-survival-of-patients-with-left-bundle-branch-block-who-are-hypo-responders-to-cardiac-resynchronization-therapy
#8
Himabindu Vidula, Valentina Kutyifa, Scott McNitt, Ilan Goldenberg, Scott D Solomon, Arthur J Moss, Wojciech Zareba
Guidelines support cardiac resynchronization therapy with a defibrillator (CRT-D) in mild heart failure (HF) patients with left bundle branch block (LBBB). However, not all patients demonstrate echocardiographic or clinical response to CRT-D. We aimed to evaluate the long-term outcomes of echocardiographic hypo-responders and clinical hypo-responders to CRT-D with LBBB in the Multicenter Automatic Defibrillator Implantation Trial with Cardiac Resynchronization Therapy. Five-hundred thirty-four patients with LBBB in the CRT-D arm were followed for 5...
June 13, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28687248/device-therapy-for-rate-control-pacing-resynchronisation-and-av-node-ablation
#9
REVIEW
Dennis H Lau, Anand Thiyagarajah, Stephan Willems, Thomas Rostock, Dominik Linz, Martin K Stiles, David Kaye, Jonathan M Kalman, Prashanthan Sanders
Atrioventricular node ablation (AVNA) is generally reserved for patients whose atrial fibrillation (AF) is refractory all other therapeutic options, since the recipients will often become pacemaker dependent. In such patients, this approach may prove particularly useful, especially if a tachycardia-induced cardiomyopathy is suspected. Historically, an "ablate and pace" approach has involved AVNA and right ventricular pacing, with or without an atrial lead. There is also an evolving role for atrioventricular node ablation in patients with AF who require cardiac resynchronization therapy for treatment of systolic heart failure...
May 31, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28683134/sex-specific-mortality-differences-in-heart-failure-patients-with-ischemia-receiving-cardiac-resynchronization-therapy
#10
Zhonglin Han, Zheng Chen, Rongfang Lan, Wencheng Di, Xiaohong Li, Hongsong Yu, Wenqing Ji, Xinlin Zhang, Biao Xu, Wei Xu
BACKGROUND: Recent studies have reported prognosis differences between male and female heart failure patients following cardiac resynchronization therapy (CRT). However, the potential clinical factors that underpin these differences remain to be elucidated. METHODS: A meta-analysis was performed to investigate the factors that characterize sex-specific differences following CRT. This analysis involved searching the Medline (Pubmed source) and Embase databases in the period from January 1980 to September 2016...
2017: PloS One
https://www.readbyqxmd.com/read/28681477/optimal-image-reconstruction-using-multidetector-row-computed-tomography-to-facilitate-cardiac-resynchronization-therapy
#11
Yu Izawa, Shumpei Mori, Tatsuya Nishii, Hiroki Matsuzoe, Hiroshi Imada, Hideya Suehiro, Kazuhiko Nakayama, Kensuke Matsumoto, Hidekazu Tanaka, Sei Fujiwara, Koji Fukuzawa, Ken-Ichi Hirata
Preprocedural recognition of the segment of latest mechanical contraction along with the anatomy of the coronary venous system is important for successful and effective cardiac resynchronization therapy. We present a case of ischemic cardiomyopathy who underwent implantation of a cardiac resynchronization therapy device with a defibrillator, which was facilitated by preprocedural computed tomographic images reconstructed to visualize the left ventricular slab and the coronary venous system simultaneously on the cardiac contour...
July 2017: Echocardiography
https://www.readbyqxmd.com/read/28680621/development-of-ventricular-fibrillation-after-implantation-of-a-biventricular-implantable-cardioverter-defibrillator-what-is-the-mechanism
#12
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/28679168/risk-stratification-of-cardiovascular-and-heart-failure-hospitalizations-using-integrated-device-diagnostics-in-patients-with-a-cardiac-resynchronization-therapy-defibrillator
#13
Haran Burri, Antoine da Costa, Aurelio Quesada, Renato Pietro Ricci, Stefano Favale, Nicolas Clementy, Gabriele Boscolo, Federico Segura Villalobos, Lorenza Mangoni di S Stefano, Vinod Sharma, Giuseppe Boriani
Aims: Cardiac resynchronization therapy defibrillators (CRT-D) are able to monitor various parameters that may be combined by an automatic algorithm to provide a heart failure risk status (HFRS). We sought to validate the HFRS for stratifying patient risk, evaluate its association with heart failure (HF) symptoms, and investigate its utility for triage of automatic alerts. Methods and results: Data from 722 patients included in the MORE-CARE trial were analysed in a post hoc analysis...
June 30, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28678701/a-planning-and-guidance-platform-for-cardiac-resynchronization-therapy
#14
Peter Mountney, Jonathan M Behar, Daniel Toth, Maria Panayiotou, Sabrina Reiml, Marie-Pierre Jolly, Rashed Karim, Li Zhang, Alexander Brost, Christopher A Rinaldi, Kawal Rhode
Patients with drug-refractory heart failure can greatly benefit from cardiac resynchronization therapy (CRT). A CRT device can resynchronize the contractions of the left ventricle (LV) leading to reduced mortality. Unfortunately 30- 50% of patients do not respond to treatment when assessed by objective criteria such as cardiac remodeling. A significant contributing factor is suboptimal placement of the LV lead. It has been shown that placing this lead away from scar and at the point of latest mechanical activation can improve response rates...
June 27, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28667454/effects-of-cardiac-resynchronization-therapy-on-right-ventricular-function-during-rest-and-exercise-as-assessed-by-radionuclide-angiography-and-on-nt-probnp-levels
#15
Cinzia Valzania, Mauro Biffi, Rachele Bonfiglioli, Francesco Fallani, Cristian Martignani, Igor Diemberger, Matteo Ziacchi, Jessica Frisoni, Luciana Tomasi, Stefano Fanti, Claudio Rapezzi, Giuseppe Boriani
AIM: We carried out this study to investigate mid-term effects of cardiac resynchronization therapy (CRT) on right ventricular (RV) function and neurohormonal response, expressed by N-terminal pro-brain natriuretic peptide (NT-proBNP), in heart failure patients stratified by baseline RV ejection fraction (RVEF). METHODS AND RESULTS: Thirty-six patients with nonischemic dilated cardiomyopathy underwent technetium-99m radionuclide angiography with bicycle exercise immediately after CRT implantation (during spontaneous rhythm and after CRT activation) and 3 months later...
June 30, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
https://www.readbyqxmd.com/read/28666618/troubleshooting-cardiac-resynchronization-therapy-in-nonresponders
#16
Sumandeep Dhesi, Evan Lockwood, Roopinder K Sandhu
Heart failure (HF) is a critical health issue. Despite the advancements in pharmacotherapy, HF-related morbidity and mortality remains high. Cardiac resynchronization therapy (CRT) has been revolutionary in medically refractory, symptomatic HF patients with reduced ejection fraction and a prolonged, abnormal QRS complex. Although CRT affects electromechanical dys-synchrony resulting in favourable ventricular remodelling, improved functional capacity and clinical outcomes with fewer HF hospitalizations and better survival, the response to CRT is not uniform...
April 23, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28666319/cause-of-death-analysis-in-patients-with-cardiac-resynchronization-therapy-with-or-without-a-defibrillator-a-systematic-review-and-proportional-meta-analysis
#17
Sérgio Barra, Rui Providência, Rudolf Duehmke, Serge Boveda, David Begley, Andrew Grace, Kumar Narayanan, Anthony Tang, Eloi Marijon, Sharad Agarwal
Aims: The additional benefit of a defibrillator in cardiac resynchronization therapy (CRT) patients is a matter of debate. Cause-of-death analysis in a CRT population has been recently proposed as a useful approach to gain insight into this problem. We performed a systematic review and meta-analysis looking at cause of death in studies involving CRT subjects with (CRT-D) or without (CRT-P) a defibrillator. Methods and results: Literature search performed from inception to 31 March 2016 for relevant studies...
June 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28663764/transvenous-versus-open-chest-lead-placement-for-resynchronization-therapy-in-patients-with-heart-failure-comparison-of-ventricular-electromechanical-synchronicity
#18
Hai-Bo Zhang, Xu Meng, Jie Han, Yan Li, Ye Zhang, Teng-Yong Jiang, Ying-Xin Zhao, Yu-Jie Zhou
BACKGROUND: Transvenous lead placement is the standard approach for left ventricular (LV) pacing in cardiac resynchronization therapy (CRT), while the open chest access epicardial lead placement is currently the most frequently used second choice. Our study aimed to compare the ventricular electromechanical synchronicity in patients with heart failure after CRT with these two different LV pacing techniques. METHODS: We enrolled 33 consecutive patients with refractory heart failure secondly to dilated cardiomyopathy who were eligible for CRT in this study...
April 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28663761/clinical-outcome-of-cardiac-resynchronization-therapy-in-dilated-phase-hypertrophic-cardiomyopathy
#19
Min Gu, Han Jin, Wei Hua, Xiao-Han Fan, Hong-Xia Niu, Tao Tian, Li-Gang Ding, Jing Wang, Cong Xue, Shu Zhang
BACKGROUNDS: Clinical trials have demonstrated that cardiac resynchronization therapy (CRT) is effective in patients with "non-ischemic cardiomyopathy". However, patients with dilated-phase hypertrophic cardiomyopathy (DHCM) have been generally excluded from such trials. We aimed to compare the clinical outcome of CRT in patients with DHCM, idiopathic dilated cardiomyopathy (IDCM), or ischemic cardiomyopathy (ICM). METHODS: A total of 312 consecutive patients (DHCM: n = 16; IDCM: n = 231; ICM: n = 65) undergoing CRT in Fuwai hospital were studied respectively...
April 2017: Journal of Geriatric Cardiology: JGC
https://www.readbyqxmd.com/read/28660601/cardiac-resynchronization-therapy-in-chronic-heart-failure-effect-on-right-ventricular-function
#20
EDITORIAL
Dominik C Benz, Aju P Pazhenkottil
No abstract text is available yet for this article.
June 28, 2017: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
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