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Cardiac Resynchronization Therapy

Nilay Patel, Juan Viles-Gonzalez, Kanishk Agnihotri, Shilpkumar Arora, Nileshkumar J Patel, Ekta Aneja, Mahek Shah, Apurva O Badheka, Naga Venkata Pothineni, Krishna Kancharla, Siva Mulpuru, Peter Noseworthy, Fred Kusumoto, Yong Mei Cha, Abhishek Deshmukh
BACKGROUND: The utilization of cardiac resynchronization therapy-defibrillator (CRT-D) has increased significantly since its initial approval for use in selected patients with heart failure. Limited data exits regarding current trends in implant related in-hospital complications and cost utilization. The aim of our study was to examine in-hospital complication rates associated with CRT-D and their trends over the last decade. METHODS AND RESULTS: Using the Nationwide Inpatient Sample, we estimated 378,248 CRT-D procedures from 2003 to 2012...
July 17, 2018: Journal of Cardiovascular Electrophysiology
Shadi Dehghanzadeh, Nahid Dehghan Nayeri, Shokoh Varaei
Heart failure is associated with low quality of life and a high mortality rate. There is limited information about patients' experiences of living with cardiac resynchronization therapy (CRT). In the present study, we sought to explore the process of living with CRT defibrillator. This qualitative study was completed from December 2014 to April 2016 using a grounded theory approach. Twenty semistructured interviews were held with 17 patients with heart failure. Data analysis was done via a previously-published approach...
July 17, 2018: Nursing & Health Sciences
Bishoy Deif, Brennan Ballantyne, Fahad Almehmadi, Michael Mikhail, William F McIntyre, Jaimie Manlucu, Raymond Yee, John L Sapp, Jason D Roberts, Jeff S Healey, Peter Leong-Sit, Anthony S Tang
Aims: Cardiac Resynchronization Therapy (CRT) has been shown to reduce mortality and heart failure (HF) hospitalization but its effects on the rate of ventricular arrhythmias (VAs) appears to be neutral. We hypothesize that CRT with LV epicardial stimulation is inherently pro-arrhythmic and increases VA rates in the absence of reverse ventricular remodelling while conferring an anti-arrhythmic effect in mechanical responders. Methods and Results: In this systematic review and meta-analysis, we considered retrospective cohort, prospective cohort and randomized controlled trials comparing VA rates between cardiac resynchronization therapy-defibrillator (CRT-D) non-responders, CRT-D responders and those with implantable cardioverter defibrillator (ICD) only...
July 14, 2018: Cardiovascular Research
Nirav Patel, Jason Gluck, Abhishek Jaiswal
No abstract text is available yet for this article.
July 12, 2018: ASAIO Journal: a Peer-reviewed Journal of the American Society for Artificial Internal Organs
Roy S Gardner, Jagmeet P Singh, Branislav Stancak, Devi G Nair, Michael Cao, Christopher Schulze, Pramodsingh H Thakur, Qi An, Scott Wehrenberg, Eric F Hammill, Yi Zhang, John P Boehmer
BACKGROUND: Care of heart failure (HF) patients results in a high burden on healthcare resources, and estimating prognosis is becoming increasingly important to triage resources wisely. Natriuretic peptides are recommended prognosticators in chronic HF. Our objective was to evaluate whether a multisensor HF index and alert algorithm (HeartLogic) replaces or augments current HF risk stratification. METHODS AND RESULTS: MultiSENSE (Multisensor Chronic Evaluation in Ambulatory Heart Failure Patients) enrolled 900 patients with cardiac resynchronization therapy defibrillators enabled for collection of heart sounds, respiration, thoracic impedance, heart rate, and activity data...
July 2018: Circulation. Heart Failure
Hassan Kamalzadeh, Shahrooz Yazdani, Mohammad Jalali
In patients with cardiac resynchronization therapy (CRT), loss of left ventricular (LV) stimulation occurs chiefly because of LV lead dislodgement. The occurrence rate of LV lead dislodgement in different reports is between 2% and 12% of patients. LV lead dislodgement precludes clinical improvement. We describe 2 patients with heart failure, fulfilling the criteria for CRT implantation. In both patients, right ventricular and right atrial leads were implanted via the left subclavian vein in the right ventricular apex and the right atrial appendage, respectively...
January 2018: Journal of Tehran Heart Center
Helder Pereira, Tom A Jackson, Benjamin Sieniewicz, Justin Gould, Cheng Yao, Steven Niederer, Christopher A Rinaldi
BACKGROUND: Cardiac resynchronization therapy (CRT) is now generally delivered via quadripolar leads. Assessment of the effect of different vector programs from quadripolar leads on ventricular activation can be now done using non-invasive electrocardiographic mapping (ECM). MATERIAL AND METHODS: In nineteen patients with quadripolar LV leads, activation maps were constructed. The total ventricular activation time (TVaT) and the time for the bulk of ventricular activation (VaT10-90 ) were calculated...
July 2018: Journal of Electrocardiology
Roksana Kisiel, Kamil Fijorek, Paweł Moskal, Piotr Kukla, Tomasz Sondej, Danuta Czarnecka, Marek Jastrzębski
We investigated prognostic value of four recently proposed ECG markers in patients with cardiac resynchronization therapy (CRT): 1./ pathological preimplantation QRS axis, 2./ increase in QRS amplitude in V3 during biventricular pacing, 3./ negative QRS in V1/V2 during left ventricular (LV)-only pacing, 4./ longer QRS duration during LV-only pacing. A longitudinal cohort study was performed (n = 552). RESULTS: During the 9-year observation period the primary endpoint (death from any cause or urgent heart transplantation) was met in 232 patients...
July 2018: Journal of Electrocardiology
Casper Lund-Andersen, Helen H Petersen, Christian Jøns, Berit T Philbert, Michael Vinther, Jesper H Svendsen
No abstract text is available yet for this article.
July 2018: Journal of Electrocardiology
Sophie Giffard-Roisin, Herve Delingette, Thomas Jackson, Jessica Webb, Lauren Fovargue, Jack Lee, C Aldo Rinaldi, Reza Razavi, Nicholas Ayache, Maxime Sermesant
GOAL: Non-invasive cardiac electrophysiology (EP) model personalisation has raised interest for instance in the scope of predicting EP cardiac resynchronization therapy (CRT) response. However, the restricted clinical applicability of current methods is due in particular to the limitation to simple situations and the important computational cost. METHODS: We propose in this manuscript an approach to tackle these two issues. First, we analyse more complex propagation patterns (multiple onsets and scar tissue) using relevance vector regression and shape dimensionality reduction on a large simulated database...
May 23, 2018: IEEE Transactions on Bio-medical Engineering
Rita Ilhão Moreira, Ana Abreu, Guilherme Portugal, Luís Oliveira, Mário Oliveira, Inês Rodrigues, Madalena Coutinho Cruz, Pedro Silva Cunha, Vanessa Santos, Helena Santa Clara, Miguel Mota Carmo, Rui Cruz Ferreira
BACKGROUND: Cardiac autonomic dysfunction as assessed by 123 I-metaiodobenzylguanidine (123 I-mIBG) scintigraphy is associated with poor prognosis in heart failure (HF) patients. Although cardiac resynchronization therapy (CRT) has emerged as an effective therapy in improving outcomes on HF patients, its effect on cardiac sympathetic nervous function is still not fully understood. We aimed to study the value of pre-implantation 123 I-mIBG late heart-to-mediastinum ratio (HMR) as a predictor of response and outcomes after CRT and to correlate modification in this parameter with CRT response and functional improvement...
July 10, 2018: Journal of Nuclear Cardiology: Official Publication of the American Society of Nuclear Cardiology
David F Briceño, David Lin
No abstract text is available yet for this article.
July 7, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
Oliver I Brown, Theodora Nikolaidou, Gowan Beddoes, Angela Hoye, Andrew L Clark
GOAL: The HF-CGM is a proof-of-principle study to investigate whether cardiogoniometry (CGM), a three-dimensional electrocardiographic method, can differentiate between pacing modes in patients with cardiac resynchronisation therapy (CRT). METHODS: At a tertiary cardiology centre, CGM recordings were performed using four pacing modes: no pacing; right ventricular (RV) pacing; left ventricular (LV) pacing and biventricular (BIV) pacing. Three orthogonal CGM planes orientated to the long axis (XY), the frontal plane (YZ) and the short axis (XZ) of the heart were constructed, and the direction of the QRS axis was calculated for each pacing mode in each plane...
November 2, 2017: IEEE Transactions on Bio-medical Engineering
M Scardigli, C Müllenbroich, E Margoni, S Cannazzaro, C Crocini, C Ferrantini, R Coppini, P Yan, L M Loew, M Campione, L Bocchi, D Giulietti, E Cerbai, C Poggesi, G Bub, F S Pavone, L Sacconi
Optogenetics has provided new insights into cardiovascular research, leading to new methods for cardiac pacing, resynchronization therapy and cardioversion. Although these interventions have clearly demonstrated the feasibility of cardiac manipulation, current optical stimulation strategies do not take into account cardiac wave dynamics in real time. Here, we developed an all-optical platform complemented by integrated, newly developed software to monitor and control electrical activity in intact mouse hearts...
July 10, 2018: Journal of Physiology
Dasheng Lu, Hao Zhang, Hongxiang Zhang
Right ventricular pacing (RVP) exerts a detrimental effect on left ventricular (LV) remodeling. In patients with atrioventricular block (AVB) that require ventricular pacing, the effect of biventricular pacing (BiVP) versus RVP on LV remodeling and function has not been comprehensively assessed in a meta-analysis. Electric databases MEDLINE and Cochrane Library were retrieved for randomized controlled trials (RCT) comparing RVP and BiVP in patients with AVB. Data on left ventricular ejection fraction (LVEF) and LV volumes were analyzed, stratified by different time points...
July 2, 2018: Heart Failure Reviews
Michael H Chiu, Jonathan G Howlett, Vikas P Kuriachan, Nakul C Sharma
A 58-year-old man with previous mitral/aortic mechanical-valve replacement, aortic root repair, and coronary disease developed severe left-ventricular dysfunction following AV-node ablation/single-chamber pacemaker implantation for management of atrial fibrillation. He then underwent an upgrade to cardiac resynchronization therapy with a defibrillator. To manage his heart failure better, angiotensin-receptor blocker therapy was changed to sacubitril/valsartan, after which symptomatic palpitations with T-wave oversensing occurred...
April 5, 2018: Canadian Journal of Cardiology
Clinton J Thurber, Keith Suarez, Javier E Banchs
CRT device implantation is complicated by a significant rate of failure to place an LV lead via the coronary sinus. The present case describes one such failure ironically leading to resynchronization. The patient's QRS narrowing subsequent to post-implant atrial pacing alone suggests that bradycardia-dependent phase 4 block was the indirect but exclusive cause of the patient's intraventricular conduction delay. Thus, phase 4 block should be considered when atrial pacing at a faster rate resolves a wide QRS interval...
June 28, 2018: Pacing and Clinical Electrophysiology: PACE
Sachin Nayyar, Adrian Suszko, Andreu Porta-Sanchez, Rupin Dalvi, Vijay S Chauhan
BACKGROUND: T-wave alternans (TWA), a marker of electrical instability, can be modulated by cardiac resynchronization therapy (CRT). The relationship between TWA and heart failure response to CRT has not been clearly defined. METHODS AND RESULTS: In 40-patients (age 65±11 years, left ventricular ejection-fraction [LVEF] 23±7%), TWA was evaluated prospectively at median of 2 months (baseline) and 8 months (follow-up) post-CRT implant. TWA-magnitude (Valt >0μV, k≥3), its duration (d), and burden (Valt ·d) were quantified in moving 128-beat segments during incremental atrial (AAI, native-TWA) and atrio-biventricular (DDD-CRT) pacing...
2018: PloS One
Liam Toner, Darragh Flannery, Hariharan Sugumar, Michelle Ord, Tina Lin, David O'Donnell
Background: Cardiac resynchronization therapy (CRT) improves morbidity and mortality in patients with heart failure. Although structural remodelling correlates with improved long-term outcomes, the role of electrical remodelling is poorly understood. This study aimed to evaluate electrical remodelling following CRT using a quadripolar left ventricular (LV) lead and to correlate this with structural remodelling. Methods: Consecutive patients undergoing initial CRT implantation using a quadripolar LV lead were enrolled...
June 2018: Journal of Arrhythmia
Nikolaos Dagres, Gerhard Hindricks
No abstract text is available yet for this article.
June 26, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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