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Cardiac Resynchronization Therapy

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https://www.readbyqxmd.com/read/29342243/devices-in-heart-failure-diagnosis-detection-and-disease-modification
#1
John Gierula, Mark T Kearney, Klaus K Witte
Introduction/background: Implantable cardiac devices are widely used in chronic heart failure (CHF) therapy. This review covers current CHF treatment with electronic cardiac devices, areas of discussion and emerging technologies. Sources of data: A comprehensive search of available literature resources including Pubmed, MEDLINE and EMBASE was performed. National and international guidelines were accessed. Areas of agreement: Excessive right ventricular pacing is detrimental to cardiac function...
January 12, 2018: British Medical Bulletin
https://www.readbyqxmd.com/read/29338475/advances-in-atrioventricular-and-interventricular-optimization-of-cardiac-resynchronization-therapy-what-s-the-gold-standard
#2
Matthew K Rowe, Gerald C Kaye
Cardiac resynchronization therapy (CRT) is one of the most important advances in heart failure management in the last twenty years. Approximately one-third of patients appear not to respond to therapy. Although there are a number of possible mechanisms for non-response, an important factor is suboptimal atrioventricular (AV) and interventricular (VV) timing intervals. There remains controversy over whether routinely optimizing intervals is necessary and there is no agreed gold standard methodology. Optimization has classically been performed using echocardiography which has limits related to resource use, time-cost and variable reproducibility...
January 16, 2018: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/29327314/computational-modeling-for-cardiac-resynchronization-therapy
#3
Angela W C Lee, Caroline Mendonca Costa, Marina Strocchi, Christopher A Rinaldi, Steven A Niederer
Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) patients with an electrical substrate pathology causing ventricular dyssynchrony. However 40-50% of patients do not respond to treatment. Cardiac modeling of the electrophysiology, electromechanics, and hemodynamics of the heart has been used to study mechanisms behind HF pathology and CRT response. Recently, multi-scale dyssynchronous HF models have been used to study optimal device settings and optimal lead locations, investigate the underlying cardiac pathophysiology, as well as investigate emerging technologies proposed to treat cardiac dyssynchrony...
January 11, 2018: Journal of Cardiovascular Translational Research
https://www.readbyqxmd.com/read/29326131/computer-modeling-the-future-of-cardiac-resynchronization-therapy-patient-selection
#4
EDITORIAL
Daniel B Cobb, Michael R Gold
No abstract text is available yet for this article.
January 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29326129/machine-learning-algorithm-predicts-cardiac-resynchronization-therapy-outcomes-lessons-from-the-companion-trial
#5
Matthew M Kalscheur, Ryan T Kipp, Matthew C Tattersall, Chaoqun Mei, Kevin A Buhr, David L DeMets, Michael E Field, Lee L Eckhardt, C David Page
BACKGROUND: Cardiac resynchronization therapy (CRT) reduces morbidity and mortality in heart failure patients with reduced left ventricular function and intraventricular conduction delay. However, individual outcomes vary significantly. This study sought to use a machine learning algorithm to develop a model to predict outcomes after CRT. METHODS AND RESULTS: Models were developed with machine learning algorithms to predict all-cause mortality or heart failure hospitalization at 12 months post-CRT in the COMPANION trial (Comparison of Medical Therapy, Pacing, and Defibrillation in Heart Failure)...
January 2018: Circulation. Arrhythmia and Electrophysiology
https://www.readbyqxmd.com/read/29325978/management-of-cardiac-implantable-electronic-devices-in-the-presence-of-left-ventricular-assist-devices
#6
Valay Parikh, Andrew Sauer, Paul Friedman, Seth H Sheldon
Left ventricular assist devices (LVAD) are increasingly utilized in the management of patients with advanced heart failure. Many of these patients have or will be considered for cardiac implantable electronic devices (CIEDs) such as an implantable cardioverter-defibrillator or cardiac resynchronization therapy device. Frequent interplay is often encountered due to complexity of these devices and the underlying disease states. Proactive management strategies and an awareness of interactions may help reduce adverse events...
January 8, 2018: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29320931/physician-decision-making-in-anticoagulating-atrial-fibrillation-a-prospective-survey-of-a-physician-notification-system-for-atrial-fibrillation-detected-on-cardiac-implantable-electronic-devices-of-patients-at-increased-risk-of-stroke
#7
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
January 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29315424/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#8
Ammar M Killu, Jae-Yoon Park, Jaskanwal D Sara, David O Hodge, Bernard J Gersh, Rick A Nishimura, Samuel J Asirvatham, Christopher J McLeod
Aims: A dilated/end-stage phase of hypertrophic cardiomyopathy (HCM) is rare but well-recognized. The role for cardiac resynchronization therapy (CRT) in this subset of patients remains unexplored. We aimed to clarify the impact of bi-ventricular pacing CRT in dilated/end-stage HCM. Methods and results: The Mayo Clinic HCM database was interrogated to identify patients with ejection fraction (EF) <50% and CRT. Control subjects were identified in 1:1 manner...
January 1, 2018: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29314424/the-interaction-of-sex-height-and-qrs-duration-on-the-effects-of-cardiac-resynchronization-therapy-on-morbidity-and-mortality-an-individual-patient-data-meta-analysis
#9
Cecilia Linde, John G F Cleland, Michael R Gold, J Claude Daubert, Anthony S L Tang, James B Young, Lou Sherfesee, William T Abraham
AIMS: To explore possible associations that may explain the greater benefit from cardiac resynchronization therapy (CRT) reported amongst women. METHODS AND RESULTS: In an individual-patient data meta-analysis of five randomized controlled trials, all-cause mortality and the composite of all-cause mortality or first hospitalization for heart failure (HF) were compared among 794 women and 2702 men assigned to CRT or a control group. Multivariable analyses were performed to assess the impact of sex, QRS duration, HF aetiology, left ventricular end-diastolic diameter (LVEDD), and height on outcome...
January 4, 2018: European Journal of Heart Failure
https://www.readbyqxmd.com/read/29314085/new-onset-left-bundle-branch-block-associated-idiopathic-nonischemic-cardiomyopathy-and-time-from-diagnosis-to-cardiac-resynchronization-therapy-the-neolith-ii-study
#10
Norman C Wang, Jack Z Li, Evan C Adelstein, Andrew D Althouse, Michael S Sharbaugh, Sandeep K Jain, G Stuart Mendenhall, Alaa A Shalaby, Andrew H Voigt, Samir Saba
BACKGROUND: The optimal timing for cardiac resynchronization therapy (CRT) after diagnosis of new-onset left bundle branch block (LBBB)-associated idiopathic nonischemic cardiomyopathy (NICM) and treatment with guideline-directed medical therapy (GDMT) is unknown. The purpose of this study was to describe relationships between time from diagnosis to CRT and outcomes in new-onset LBBB-associated idiopathic NICM with LVEF ≤35%. METHODS: A retrospective cohort study examined associations between time from diagnosis to CRT (≤9 months versus > 9 months) and clinical and echocardiographic outcomes...
January 4, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29313369/characteristics-and-prognosis-of-heart-failure-with-improved-compared-with-persistently-reduced-ejection-fraction-a-systematic-review-and-meta-analyses
#11
Mads E Jørgensen, Charlotte Andersson, Ramachandran S Vasan, Lars Køber, Jawdat Abdulla
Aims We assessed the clinical characteristics and prognosis of chronic heart failure patients with improved ejection fraction (HFIEF) compared with persistently reduced ejection fraction (HFpREF) after evidence-based therapy. Methods and results We performed a meta-analysis including 24 eligible observational studies comparing 2663 HFIEF (≥5% left ventricular ejection fraction (LVEF) improvement) versus 8355 HFpREF patients who received recommended drug therapy, cardiac resynchronization therapy and/or intracardiac defibrillator...
January 1, 2018: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/29309556/statistics-on-the-use-of-cardiac-electronic-devices-and-interventional-electrophysiological-procedures-in-africa-from-2011-to-2016-report-of-the-pan-african-society-of-cardiology-pascar-cardiac-arrhythmias-and-pacing-task-forces
#12
Aimé Bonny, Marcus Ngantcha, Mohamed Jeilan, Emmy Okello, Bundhoo Kaviraj, Mohammed A Talle, George Nel, Eloi Marijon, Mahmoud U San, Zaheer Yousef, Kamilu M Karaye, Ibrahim A Touré, Mohamed A Awad, George Millogo, Jonas Kologo, Adama Kane, Romain Houndolo, Anastase Dzudié, Amam Mbakwem, Bongani M Mayosi, Ashley Chin
Aims: To provide comprehensive information on the access and use of cardiac implantable electronic devices (CIED) and catheter ablation procedures in Africa. Methods and results: The Pan-African Society of Cardiology (PASCAR) collected data on invasive management of cardiac arrhythmias from 2011 to 2016 from 31 African countries. A specific template was completed by physicians, and additional information obtained from industry. Information on health care systems, demographics, economics, procedure rates, and specific training programs was collected...
December 21, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29308851/redo-procedures-and-chronic-renal-dysfunction-are-associated-with-higher-risk-of-cardiac-electronic-device-infections
#13
Giovanni Morani, Giacomo Mugnai, Bruna Bolzan, Martina Morosato, Luca Tomasi, Sara Ferrari, Corrado Vassanelli
BACKGROUND: Infection is a major complication of pacemaker (PM) and implantable cardioverter-defibrillator (ICD) implantation. The present study sought to analyse the incidence rate of device infections, to investigate possible relationships between first implantations/repeated procedures and infection rates, and to identify some main risk factors associated with infection of cardiac implantable electronic devices (CIED). METHODS: In a single center retrospective observational study, records of 3899 consecutive patients having undergone PM and ICD implantation, cardiac resynchronization therapy (CRT) or revision (device/lead replacements or upgrades) and between 2002 and 2012 were obtained...
January 5, 2018: Minerva Cardioangiologica
https://www.readbyqxmd.com/read/29300970/patients-knowledge-and-attitudes-regarding-living-with-implantable-electronic-devices-results-of-a-multicentre-multinational-patient-survey-conducted-by-the-european-heart-rhythm-association
#14
Kristina Hermann Haugaa, Tatjana S Potpara, Serge Boveda, Jean-Calude Deharo, Jian Chen, Dan Dobreanu, Stefano Fumagalli, Radoslaw Lenarczyk, Antonio Hernandez Madrid, Torben Bjerregaard Larsen, Elena Sciarrafia, Milos Taborsky, Roland Richard Tilz, Paolo Pieragnoli, Andrzej Przybylski, Nikolaos Dagres
The purpose of this patient survey was to analyse the knowledge, experiences, and attitudes regarding cardiac implantable electronic devices (CIED) in patients with pacemakers, implantable cardioverter-defibrillators (ICDs), or cardiac resynchronization devices. Of the 1644 patients with CIEDs from seven European countries, 88% were over 50 years of age. Most patients (90%) knew what device they were implanted with and felt sufficiently informed about the indications for therapy. As many as 42% of patients needed additional information on the battery replacement and limitations in physical activity...
December 28, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/29300199/recent-advances-in-heart-failure
#15
Mahwash Kassi, Bashar Hannawi, Barry Trachtenberg
PURPOSE OF REVIEW: Acute heart failure continues to be a challenge as there is limited benefit of numerous agents that have been tested. Cardiac resynchronization therapy remains standard of care, yet timing and need for implantable cardiac defibrillator has been brought into question with the recent randomized trials. Several recent advances have been made towards management of heart failure both in drug and device therapy. The purpose of this review is to provide an update on the most important recent studies on heart failure with reduced ejection fraction (HFrEF) and heart failure with preserved ejection fraction (HFpEF)...
January 2, 2018: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/29297189/are-changes-in-heart-rate-observed-during-dobutamine-stress-echocardiography-associated-with-a-response-to-cardiac-resynchronization-therapy-in-patients-with-severe-heart-failure-results-of-a-multicenter-viacrt-study
#16
Wojciech Gilewski, Jan Błażejewski, Danuta Karasek, Joanna Banach, Łukasz Wołowiec, Edyta Płońska-Gościniak, Tomasz Kukulski, Jarosław Kasprzak, Katarzyna Mizia-Stec, Ilona Kowalik, Piotr Gościniak, Władysław Sinkiewicz
BACKGROUND: According to current ESC Guidelines for the diagnosis and treatment of heart failure cardiac resynchronization therapy (CRT) is indicated in patients suffering from heart failure (HF) with reduced ejection fraction (EF) with significantly widened QRS complexes. Presence of vital myocardium proved by dobutamine stress echocardiography (DSE) is considered as a good prognostic factor for responsiveness to this treatment. Chronotropic incompetence is on the other hand known factor of unfavorable outcome in HF...
January 3, 2018: Kardiologia Polska
https://www.readbyqxmd.com/read/29290021/dl-3-n-butylphthalide-reduces-atrial-fibrillation-susceptibility-by-inhibiting-atrial-structural-remodeling-in-rats-with-heart-failure
#17
Huiliang Qiu, Huanlin Wu, Jin Ma, Haiming Cao, Lihua Huang, Wencong Qiu, Ying Peng, Chunhua Ding
Agents against atrial structural remodeling (ASR) are thought to block the occurrence of atrial fibrillation (AF). The aim of this study was to investigate the effects of DL-3-n-butylphthalide (NBP) on ASR and AF formation in rats with heart failure (HF) induced by myocardial infarction. The heart failure rats established 1 week after ligating left anterior descending coronary artery were randomly treated with vehicle (HF group, n = 24), or treated with DL-3-n-butylphthalide (100 mg/kg body weight) (NBP group, n = 26) for 4 weeks...
December 30, 2017: Naunyn-Schmiedeberg's Archives of Pharmacology
https://www.readbyqxmd.com/read/29288035/clinical-impact-of-an-additional-left-ventricular-lead-in-cardiac-resynchronization-non-responders-the-v3-trial
#18
Pierre Bordachar, Daniel Gras, Nicolas Clementy, Pascal Defaye, Pierre Mondoly, Serge Boveda, Frederic Anselme, PhD, Didier Klug, Olivier Piot, Nicolas Sadoul, Dominique Babuty, Christophe Leclercq
BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment of heart failure (HF), but is limited by a substantial proportion of non-responders. We hypothesized that adding a second left ventricular (LV) lead to deliver a triple site CRT (V3 CRT) may improve clinical status of CRT non-responders. OBJECTIVE: We assessed the feasibility and safety of adding a second LV lead to CRT non-responders and its clinical impact. METHODS: 84 patients recipients of a CRT system and considered as non-responders as per Clinical Composite Score (CCS) were enrolled in this multi-center study...
December 26, 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/29286395/benefits-of-cardiac-resynchronization-therapy-in-an-asynchronous-heart-failure-model-induced-by-left-bundle-branch-ablation-and-rapid-pacing
#19
Jingfeng Wang, Zhenning Nie, Haiyan Chen, Xianhong Shu, Zhaohua Yang, Ruiming Yao, Yangang Su, Junbo Ge
It is now well recognized that heart failure (HF) patients with left bundle branch block (LBBB) derive substantial clinical benefits from cardiac resynchronization therapy (CRT), and LBBB has become one of the important predictors for CRT response. The conventional tachypacing-induced HF model has several major limitations, including absence of stable LBBB and rapid reversal of left ventricular (LV) dysfunction after cessation of pacing. Hence, it is essential to establish an optimal model of chronic HF with isolated LBBB for studying CRT benefits...
December 11, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29283915/diagnostic-power-and-healthcare-resource-consumption-of-a-dedicated-workflow-algorithm-designed-to-manage-thoracic-impedance-alerts-in-heart-failure-patients-by-remote-monitoring
#20
Renato P Ricci, Loredana Morichelli, Antonio Porfili, Laura Quarta, Anna Sassi
PURPOSE: Modern cardiac implantable devices provide diagnostic information on several physiological variables which are associated with worsening heart failure, creating an opportunity for early intervention to prevent heart failure symptoms and hospitalizations. We evaluated diagnostic accuracy and workload of a remote monitoring (RM) workflow algorithm which leverages intrathoracic impedance and other device diagnostics. METHODS: In our RM workflow a team of expert nurses was responsible for continuity of care, direct relationship with patients and implementation of a specific protocol to evaluate RM alerts and to limit unnecessary resource consumption...
December 27, 2017: Journal of Cardiovascular Medicine
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