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Daniel J Friedman, Haikun Bao, Erica S Spatz, Jeptha P Curtis, James P Daubert, Sana M Al-Khatib
BACKGROUND: -A prolonged PR interval is common among cardiac resynchronization therapy (CRT) candidates; however, the association between PR interval and outcomes is unclear, and data are conflicting. METHODS: -We conducted inverse probability weighted (IPW) analyses of 26,451 CRT eligible (EF≤35, QRS≥120ms) patients from the National Cardiovascular Data Registry ICD Registry to assess the association between a prolonged PR interval (≥230ms), receipt of CRT with defibrillator (CRT-D) versus implantable cardioverter defibrillator (ICD), and outcomes...
October 19, 2016: Circulation
Marie Christine Iliou, Jean Christophe Blanchard, Aurélia Lamar-Tanguy, Pascal Cristofini, François Ledru
Large subsets of patients admitted in cardiac rehabilitation centers are having a pacemaker, cardiac resynchronization (CRT) or implantable cardiac defibrillator (ICD). Cardiac rehabilitation for patients, mostly with heart failure, with implanted electronic devices as pacemakers or ICD is a unique opportunity not only to optimize the medical treatment, to increase their exercise capacity and improves their clinical condition but also to supervise the correct functioning of the device. CRT reduces clinical symptoms and increases slightly the exercise capacity...
October 14, 2016: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
Martin Grett, Martin Christ, Hans-Joachim Trappe
BACKGROUND: Little is known about the incidence and risk factors for progression to pacemaker dependency or the need for cardiac resynchronization in typical patients with an implanted defibrillator with regard to an alternative implantation of a subcutaneous ICD (S-ICD). STUDY DESIGN AND METHODS: After retrospective analysis of 291 patients with first implantation of a transvenous single chamber ICD (VVI-ICD) from 2010-2016 and excluding those with an indication for pacemaker or lack of follow-up data, 121 patients were included and investigated with regard to the following endpoints: need for pacemaker stimulation, upgrade for cardiac resynchronization (CRT), and secondary occurrence and effectiveness of antitachycardia pacing (ATP)...
October 13, 2016: Herzschrittmachertherapie & Elektrophysiologie
Mateusz Tajstra, Elżbieta Gadula-Gacek, Anna Kurek, Elżbieta Adamowicz-Czoch, Dawid Olszowski, Mateusz Ostręga, Aneta Ciślak, Łukasz Pyka, Michał Hawranek, Andrzej Lekston, Lech Poloński, Mariusz Gąsior
BACKGROUND: Current real-life information from all-comers registries from middle and east Europe about the incidence and type of complications during long-term follow-up of patients with cardioverters-defibrillators (ICD) and cardiac resynchronization devices-defibrillators (CRT-D) is still insufficient. The aim of the study was to assess the incidence and determinants of short- and long-term complications related to implantable ICD and CRT-D. METHODS: We studied 1,105 recipients hospitalized in our center in 2009-2013, followed for a mean of 2...
October 13, 2016: Cardiology Journal
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
Philipp Attanasio, Melika Mirdamadi, Jean-Yves Wielandts, Burkert Pieske, Florian Blaschke, Leif-Hendrik Boldt, Pierre Jais, Wilhelm Haverkamp, Martin Huemer
AIMS: For cardiac implantable electronic device (CIED) implantations, visualization of lead placement is necessary and fluoroscopy remains by far the most commonly used technique. With simple changes in the X-ray system settings, total radiation dose can be reduced significantly. The purpose of this study was to assess the safety and efficacy of various CIED implantations performed after implementation of a new dose reduction protocol (DRP). METHODS AND RESULTS: We conducted a retrospective chart review of 584 patients undergoing CIED implantation or revision in our hospital...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Maurizio Landolina, Giovanni Morani, Antonio Curnis, Antonello Vado, Antonio D'Onofrio, Valter Bianchi, Giuseppe Stabile, Martino Crosato, Barbara Petracci, Carlo Ceriotti, Luca Bontempi, Martina Morosato, Gian Paolo Ballari, Maurizio Gasparini
AIMS: Patients receiving cardiac resynchronization therapy defibrillators (CRT-Ds) are likely to undergo one or more device replacements, mainly for battery depletion. We assessed the economic impact of battery depletion on the overall cost of CRT-D treatment from the perspectives of the healthcare system and the hospital. We also compared devices of different generations and from different manufacturers in terms of therapy cost. METHODS AND RESULTS: We analysed data on 1792 CRT-Ds implanted in 1399 patients in 9 Italian centres...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Eran Leshem, Mahmoud Suleiman, Avishag Laish-Farkash, Yuval Konstantino, Michael Glikson, Alon Barsheshet, Ilan Goldenberg, Yoav Michowitz
AIMS: Dual-coil leads were traditionally considered standard of care due to lower defibrillation thresholds (DFT). Higher complication rates during extraction with parallel progression in implantable cardioverter defibrillator (ICD) technology raised questions on dual coil necessity. Prior substudies found no significant outcome difference between dual and single coils, although using higher rates of DFT testing then currently practiced. We evaluated the temporal trends in implantation rates of single- vs...
October 4, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
Christine M Tompkins, Scott McNitt, Bronislava Polonsky, James P Daubert, Paul J Wang, Arthur J Moss, Wojciech Zareba, Valentina Kutyifa
INTRODUCTION: Approximately 10-20% of ICD recipients receive inappropriate device therapies. The purpose of this study was to compare the frequency of inappropriate therapies (IT) between men and women enrolled in MADIT II and MADIT-CRT, and assess for potential adverse outcomes. METHODS: The electrograms for each ICD or CRT-D therapy, defined as either ATP or shock, were reviewed by adjudication committees for both studies. ICD therapy was considered inappropriate if it was delivered for reasons other than VT/VF...
October 2, 2016: Journal of Cardiovascular Electrophysiology
D O Verschure, B L F van Eck-Smit, G A Somsen, R J J Knol, H J Verberne
Heart failure is a life-threatening disease with a growing incidence in the Netherlands. This growing incidence is related to increased life expectancy, improvement of survival after myocardial infarction and better treatment options for heart failure. As a consequence, the costs related to heart failure care will increase. Despite huge improvements in treatment, the prognosis remains unfavourable with high one-year mortality rates. The introduction of implantable devices such as implantable cardioverter defibrillators (ICD) and cardiac resynchronisation therapy (CRT) has improved the overall survival of patients with chronic heart failure...
September 27, 2016: Netherlands Heart Journal
S C Blamek, M Tajstra, E Gadula-Gacek, D Gabryś, B Niewiadomska, A Bekman, L Dolla, M Gąsior
No abstract text is available yet for this article.
October 1, 2016: International Journal of Radiation Oncology, Biology, Physics
Wilbert S Aronow
Heart failure is the commonest cause of hospitalization and of rehospitalization This review paper is a comprehensive review of current treatment of heart failure in 2016. The target of this review is all health care professionals who treat patients with heart failure. Areas covered: This article discusses stages of heart failure, treatment of heart failure with general measures, and drug therapy with diuretics, angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta blockers, aldosterone antagonists, isosorbide dinitrate plus hydralazine, digoxin, other neurohormonal antagonists, sacubitril/valsartan, calcium channel blockers, and ivabradine...
October 11, 2016: Expert Review of Clinical Pharmacology
Laurent Fauchier, Christine Alonso, Frédéric Anselme, Hugues Blangy, Pierre Bordachar, Serge Boveda, Nicolas Clementy, Pascal Defaye, Jean-Claude Deharo, Patrick Friocourt, Daniel Gras, Franck Halimi, Didier Klug, Jacques Mansourati, Benjamin Obadia, Jean-Luc Pasquié, Dominique Pavin, Nicolas Sadoul, Jérôme Taieb, Olivier Piot, Olivier Hanon
Despite the increasingly high rate of implantation of pacemakers (PM) and cardioverter-defibrillators (ICD) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety, and effectiveness of the conventional pacing, ICD and cardiac resynchronization therapy (CRT) in elderly patients. Although peri-procedural risk may be slightly higher in the elderly, the procedure of implantation of PMs and ICDs is still relatively safe in this age group...
September 1, 2016: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
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
Usama A Daimee, Yitschak Biton, Arthur J Moss, Wojciech Zareba, David Cannom, Helmut Klein, Scott Solomon, Martin H Ruwald, Scott McNitt, Bronislava Polonsky, Paul J Wang, Ilan Goldenberg, Valentina Kutyifa
BACKGROUND: The effect of chronic kidney disease (CKD) on benefit from cardiac resynchronization therapy with defibrillator (CRT-D) in reducing ventricular tachyarrhythmia (VTA) risk among mild heart failure (HF) patients is not well understood. METHODS: We evaluated the impact of baseline renal function on VTAs in 1274 left bundle branch block (LBBB) patients enrolled in MADIT-CRT. Two prespecified subgroups were created based on estimated glomerular filtration rate (GFR): GFR <60 (n = 413) and GFR ≥60 ml/min/1...
September 15, 2016: Annals of Noninvasive Electrocardiology
Chance M Witt, Gang Wu, Dachun Yang, David O Hodge, Veronique L Roger, Yong-Mei Cha
OBJECTIVES: This study aimed to define the prognosis for patients with left bundle branch block (LBBB) and a mildly to moderately reduced left ventricular ejection fraction (LVEF) (36% to 50%) as well as to clarify whether LBBB remained a negative prognostic marker in this group. BACKGROUND: LBBB is associated with worse outcomes in patients with heart failure in the setting of severely reduced LVEF. The level of morbidity and mortality associated with LBBB in the setting of a mildly to moderately reduced LVEF (36% to 50%) has not been clearly characterized...
August 28, 2016: JACC. Heart Failure
Raffaele Corbisiero, David C Buck, David Muller, Rupinder Bharmi, Nirav Dalal, Pedram Kazemian
BACKGROUND: Cardiac resynchronization therapy (CRT) is an effective treatment for heart failure (HF) with left ventricular systolic dysfunction and prolonged QRS interval. However, one third of patients do not benefit from treatment. This study compares the heart failure hospitalization (HFH) rates and corresponding costs between responders and non-responders to CRT. METHODS: At a single center in New Jersey, we enrolled patients with de novo CRT-D implants between January 2011 and July 2013...
September 9, 2016: Journal of Interventional Cardiac Electrophysiology: An International Journal of Arrhythmias and Pacing
Shuang Zhao, Keping Chen, Yangang Su, Wei Hua, Jiefu Yang, Silin Chen, Zhaoguang Liang, Wei Xu, Shu Zhang
BACKGROUND: Left ventricular ejection fraction (LVEF) ≤35% is the cutoff value used to identify patients at high risk of sudden cardiac death. However, whether patients who have moderate left ventricular dysfunction and left ventricular enlargement (LVE) have a high risk of ventricular arrhythmias (VAs) and cardiac death is unclear. HYPOTHESIS: Patients with moderate left ventricular dysfunction and LVE may have a high risk of VAs. METHODS: This study retrospectively analyzed the data of 853 patients who have an implantable cardioverter-defibrillator/cardiac resynchronization therapy cardioverter-defibrillator equipped with home monitoring...
September 9, 2016: Clinical Cardiology
Jens Jakob Thune, Steen Pehrson, Jens Cosedis Nielsen, Jens Haarbo, Lars Videbæk, Eva Korup, Gunnar Jensen, Per Hildebrandt, Flemming Hald Steffensen, Niels Eske Bruun, Hans Eiskjær, Axel Brandes, Anna Margrethe Thøgersen, Kenneth Egstrup, Jesper Hastrup-Svendsen, Dan Eik Høfsten, Christian Torp-Pedersen, Lars Køber
BACKGROUND: The effect of an implantable cardioverter defibrillator (ICD) in patients with symptomatic systolic heart failure (HF) caused by coronary artery disease is well documented. However, the effect of primary prophylactic ICDs in patients with systolic HF not due to coronary artery disease is much weaker. In addition, HF management has improved, since the landmark ICD trials and a large proportion of patients now receive cardiac resynchronization therapy (CRT) where the effect of ICD treatment is unknown...
September 2016: American Heart Journal
Laurent Fauchier, Christine Alonso, Frederic Anselme, Hugues Blangy, Pierre Bordachar, Serge Boveda, Nicolas Clementy, Pascal Defaye, Jean-Claude Deharo, Patrick Friocourt, Daniel Gras, Franck Halimi, Didier Klug, Jacques Mansourati, Benjamin Obadia, Jean-Luc Pasquié, Dominique Pavin, Nicolas Sadoul, Jerome Taieb, Olivier Piot, Olivier Hanon
Despite the increasingly high rate of implantation of pacemakers (PMs) and implantable cardioverter defibrillators (ICDs) in elderly patients, data supporting their clinical and cost-effectiveness in this age stratum are ambiguous and contradictory. We reviewed the data regarding the applicability, safety and effectiveness of conventional pacing, ICDs and cardiac resynchronization therapy (CRT) in elderly patients. Although periprocedural risk may be slightly higher in the elderly, the implantation procedure for PMs and ICDs is still relatively safe in this age group...
October 2016: Archives of Cardiovascular Diseases
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