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John Rickard, Henry Michtalik, Ritu Sharma, Zackary Berger, Emmanuel Iyoha, Ariel R Green, Nowreen Haq, Karen A Robinson
BACKGROUND: Multiple studies have sought to determine variables associated with improved "response" to cardiac resynchronization therapy(CRT). Such variables, however, are often derived from inadequately controlled, single center cohort studies calling external validity into question. We sought to determine predictors of response to CRT-D and CRT-P utilizing the methods of systematic review. METHODS: We searched MEDLINE, Embase®, and the Cochrane Central Register of Controlled Trials (CENTRAL) from January 1, 1995, as this is the date of first article reporting use of CRT through October 20, 2014...
September 25, 2016: International Journal of Cardiology
Avishag Laish-Farkash, Sharon Bruoha, Amos Katz, Ilan Goldenberg, Mahmoud Suleiman, Yoav Michowitz, Nir Shlomo, Michal Einhorn-Cohen, Vladimir Khalameizer
AIMS: Cardiac resynchronization therapy (CRT) with a defibrillator (CRT-D) has downsides of high cost and inappropriate shocks compared to CRT without a defibrillator (CRT-P). Recent data suggest that the survival benefit of implantable cardioverter defibrillator (ICD) therapy is attenuated in the older age group. We hypothesized that, among octogenarians eligible for cardiac resynchronization therapy, CRT-P confers similar morbidity and mortality benefits as CRT-D. METHODS AND RESULTS: We compared morbidity and mortality outcomes between consecutive octogenarian patients eligible for CRT therapy who underwent CRT-P implantation at Barzilai MC (n = 142) vs...
October 12, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Hyeon Woo Lim, Tae Hyun Kim, Il Ju Choi, Chan Gyoo Kim, Jong Yeul Lee, Soo Jeong Cho, Hyeon Seok Eom, Sung Ho Moon, Dae Yong Kim
PURPOSE: To assess the clinical outcomes of radiotherapy (RT) using two-dimensional (2D) and three-dimensional conformal RT (3D-CRT) for patients with gastric mucosa-associated lymphoid tissue (MALT) lymphoma to evaluate the effectiveness of involved field RT with moderate-dose and to evaluate the benefit of 3D-CRT comparing with 2D-RT. MATERIALS AND METHODS: Between July 2003 and March 2015, 33 patients with stage IE and IIE gastric MALT lymphoma received RT were analyzed...
September 2016: Radiation Oncology Journal
Julia W Erath, Abdul Sami Sirat, Mate Vamos, Stefan H Hohnloser
Persistent left superior vena cava is known to be a challenging anatomic abnormality for transvenous cardiac device implantation. In the a case of a young man presenting with dilative cardiomyopathy with severely impaired left ventricular ejection fraction (LVEF) and second-degree atrioventricular block (AV block), cardiac resynchronization therapy (CRT) with defibrillator (CRT-D) implantation was indicated. A transvenous approach was attempted, but placement of the right ventricular lead was not successful due to anatomic abnormalities...
September 19, 2016: Herzschrittmachertherapie & Elektrophysiologie
Kai Januschowski, Nicolas Feltgen, Amelie Pielen, Bernhard Spitzer, Matus Rehak, Georg Spital, Spyridon Dimopoulos, Carsten H Meyer, Gesine B Szurman
PURPOSE: Vision loss in central retinal vein occlusion (CRVO) is mostly caused by macular edema (ME) and can be treated with intravitreal bevacizumab injections. The goal of this study was to identify predictive factors for improvement in visual acuity. METHODS: Three hundred and sixteen eyes of six centres having received intravitreal bevacizumab for ME due to CRVO were enrolled in this multicentre, retrospective, interventional case series. The follow-up time was 24 to 48 weeks...
September 8, 2016: Graefe's Archive for Clinical and Experimental Ophthalmology
Kanmin Xue, Elizabeth Yang, N Victor Chong
AIMS: To characterise differential pathogeneses of diabetic macular oedema (DMO) using ultra-widefield fluorescein angiography (UWFA) and evaluate responses to anti-vascular endothelial growth factor (anti-VEGF) therapy. METHODS: Ninety-nine eyes (73 consecutive patients) with anti-VEGF naïve DMO underwent UWFA and optical coherence tomography, of which 60 with central retinal thickness (CRT) >400 μm received monthly intravitreal ranibizumab injections. Best-corrected visual acuity (BCVA) and CRT were measured at baseline and after three injections...
August 16, 2016: British Journal of Ophthalmology
Molly K Barnhart, Elizabeth C Ward, Bena Cartmill, Rachelle A Robinson, Virginia A Simms, Sophie J Chandler, Elea T Wurth, Robert I Smee
A proportion of patients with head and neck cancer (HNC) experience significant swallowing difficulty during and post-radiotherapy/chemoradiotherapy (RT/CRT). Identifying patients during the pretreatment period who are anticipated to have compromised oral intake would allow for early and accurate patient education, and prioritisation of their management. Ascertaining a clear set of pretreatment predictors from the literature is challenging due to heterogeneity in study designs and patient cohorts, with minimal prospective data available (especially at 1-month post-treatment)...
August 6, 2016: European Archives of Oto-rhino-laryngology
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
P D Larsen, A J Kerr, M Hood, S A Harding, D Hooks, D Heaven, N A Lever, S Sinclair, D Boddington, E W Tang, J Swampillai, M K Stiles
BACKGROUND: The New Zealand Cardiac Implanted Device Registry (Device) has recently been developed under the auspices of the New Zealand Branch of the Cardiac Society of Australia and New Zealand. This study describes the initial Device registry cohort of patients receiving a new pacemaker, their indications for pacing and their perioperative complications. METHODS: The Device Registry was used to audit patients receiving a first pacemaker between 1(st) January 2014 and 1(st) June 2015...
July 19, 2016: Heart, Lung & Circulation
Laura A Hatfield, Daniel B Kramer, Rita Volya, Matthew R Reynolds, Sharon-Lise T Normand
BACKGROUND: Cardiac implantable electric devices are commonly used to treat heart failure. Little is known about temporal and geographic variation in use of cardiac resynchronization therapy (CRT) devices in usual care settings. METHODS AND RESULTS: We identified new CRT with pacemaker (CRT-P) or defibrillator generators (CRT-D) implanted between 2008 and 2013 in the United States from a commercial claims database. For each implant, we characterized prior medication use, comorbidities, and geography...
August 2016: Journal of the American Heart Association
Mutlay Sayan, Prashant Vempati, Brett Miles, Marita Teng, Eric Genden, Elizabeth G Demicco, Krzysztof Misiukiewicz, Marshall Posner, Vishal Gupta, Richard L Bakst
AIM: We compared the clinical outcomes and toxicity profile among a retrospective cohort of patients with primary major salivary gland carcinomas (SGCs) treated with surgery followed by adjuvant radiation therapy (S+RT) versus surgery and adjuvant chemoradiotherapy (S+CRT). PATIENTS AND METHODS: Twenty patients (71%) underwent S+RT and eight (29%) S+CRT at our Institution between 2006 and 2015. Microscopic positive margins were present in 54% of the patients. RESULTS: The 3-year overall survival (OS) was 100% with S+RT and 87...
August 2016: Anticancer Research
Evrim Duman, Aysun Inal, Aycan Sengul, Timur Koca, Yigit Cecen, Melek Nur Yavuz
AIM: The study evaluates the different treatment planning techniques according to three recommendation levels of the International Commission on Radiation Units and Measurements Report-83 in gynecologic cancer patients treated with adjuvant pelvic radiotherapy (APR). MATERIALS AND METHODS: Computerized tomography images of ten endometrial and cervical cancer patients who were treated with APR were assessed. For each patient, five different treatment plans were created...
April 2016: Journal of Cancer Research and Therapeutics
Stefan Münch, Sylvia Aichmeier, Alexander Hapfelmeier, Marciana-Nona Duma, Markus Oechsner, Marcus Feith, Stephanie E Combs, Daniel Habermehl
PURPOSE: Volumetric-modulated arc therapy (VMAT) achieves high conformity to the planned target volume (PTV) and good sparing of organs at risk (OAR). This study compares dosimetric parameters and toxicity in esophageal cancer (EC) patients treated with VMAT and 3D conformal radiotherapy (3D-CRT). MATERIALS AND METHODS: Between 2007 and 2014, 17 SC patients received neoadjuvant chemoradiation (CRT) with VMAT. Dose-volume histograms and toxicity were compared between these patients and 20 treated with 3D-CRT...
October 2016: Strahlentherapie und Onkologie: Organ der Deutschen Röntgengesellschaft ... [et Al]
Nitish Badhwar, Jameze James, Kurt S Hoffmayer, John W O'Connell, Deanna L Green, Teresa De Marco, Elias H Botvinick
OBJECTIVE: We evaluated a novel scintigraphic method employing new parameters of mechanical left ventricular (LV) dyssynchrony and correlated it with clinical outcomes in heart failure patients with reduced ejection fraction (HFrEF) receiving cardiac resynchronization therapy (CRT). METHODS: Sixty-six advanced HF patients referred for CRT with LV ejection fraction (EF) <35% and QRS ≥120 ms were studied. We performed equilibrium radionuclide angiography (ERNA) prior to and six months after CRT...
July 14, 2016: Journal of Nuclear Medicine: Official Publication, Society of Nuclear Medicine
Stuart Mealing, Beth Woods, Neil Hawkins, Martin R Cowie, Christopher J Plummer, William T Abraham, John F Beshai, Helmut Klein, Mark Sculpher
OBJECTIVE: To evaluate the cost-effectiveness of implantable cardioverter defibrillators (ICDs), cardiac resynchronisation therapy pacemakers (CRT-Ps) and combination therapy (CRT-D) in patients with heart failure with reduced ejection fraction based on a range of clinical characteristics. METHODS: Individual patient data from 13 randomised trials were used to inform a decision analytical model. A series of regression equations were used to predict baseline all-cause mortality, hospitalisation rates and health-related quality of life and device-related treatment effects...
July 13, 2016: Heart: Official Journal of the British Cardiac Society
Wim Ceelen, Wouter Willaert, Machteld Varewyck, Sasha Libbrecht, Els Goetghebeur, Piet Pattyn
BACKGROUND: It is unknown how neoadjuvant treatment schedule affects lymph node count (LNC) and lymph node ratio (LNR) and how these correlate with overall survival (OS) in rectal cancer (RC). METHODS: Data were used from the Belgian PROCARE rectal cancer registry on RC patients treated with surgery alone, short-term radiotherapy with immediate surgery (SRT), or chemoradiation with deferred surgery (CRT). The effect of neoadjuvant therapy on LNC was examined using Poisson log-linear analysis...
July 5, 2016: Annals of Surgical Oncology
Oguz Karaca, Haci M Gunes, Mehmet Onur Omaygenc, Beytullah Cakal, Sinem Deniz Cakal, Gultekin Gunhan Demir, Filiz Kizilirmak, Tayyar Gokdeniz, Irfan Barutcu, Bilal Boztosun, Fethi Kilicaslan
BACKGROUND: Although response to cardiac resynchronization therapy (CRT) has been conventionally assessed with left ventricular volume reduction, ventricular arrhythmias (ventricular tachycardia/ventricular fibrillation [VT/VF]) are of critical importance associated with unfavorable outcomes even in the "superresponders" to therapy. We evaluated the predictors of VT/VF and the association of residual dyssynchrony during follow-up. METHODS: Ninety-five patients receiving CRT were followed-up for 9 ± 3 months...
September 2016: Pacing and Clinical Electrophysiology: PACE
Roland Tilz, Serge Boveda, Jean-Claude Deharo, Dan Dobreanu, Kristina H Haugaa, Nikolaos Dagres
The aim of this EP Wire was to assess the management, indications, and techniques for implantable cardioverter defibrillator (ICD) and cardiac resynchronization therapy (CRT) device replacement in Europe. A total of 24 centres in 14 European countries completed the questionnaire. All centres were members of the European Heart Rhythm Association Electrophysiology Research Network. Replacement procedures were performed by electrophysiologists in 52% of the centres, by cardiologists in 33%, and both in the remaining centres...
June 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
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
María Nombela-Palomo, Gema Felipe-Marquez, Jose Luis Hernandez-Verdejo, Amelia Nieto-Bona
OBJECTIVE: To assess the effects of a short period of orthokeratology (OK) on corneal subbasal nerve plexus (SBNP) morphology and corneal sensitivity. METHODS: Measurements were made in 56 right eyes of 56 subjects with low-to-moderate myopia who wore 2 OK lens designs (Group CRT: HDS 100 Paragon CRT, n=35; Group SF: Seefree; n=21) for a period of 1 month and in 15 right eyes of noncontact lens wearers as controls. The variables determined in each participant were corneal sensitivity using a Cochet-Bonnet esthesiometer and 12 SBNP variables determined on laser scanning confocal microscopy images using 3 different software packages...
May 26, 2016: Eye & Contact Lens
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