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https://www.readbyqxmd.com/read/29759832/safety-and-efficacy-of-multipoint-pacing-in-cardiac-resynchronization-therapy-the-multipoint-pacing-trial
#1
Imran Niazi, James Baker, Raffaele Corbisiero, Charles Love, David Martin, Robert Sheppard, Seth J Worley, Niraj Varma, Kwangdeok Lee, Gery Tomassoni
OBJECTIVES: The MultiPoint Pacing (MPP) trial assessed the safety and efficacy of pacing 2 left ventricular sites with a quadripolar lead in patients with heart failure indicated for a CRT-D device. BACKGROUND: Cardiac resynchronization therapy nonresponse is a complex problem where stimulation of multiple left ventricular sites may be a solution. METHODS: Enrolled patients were indicated for a CRT-D system. Bi-ventricular (Bi-V) pacing was activated at implant...
December 26, 2017: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29721114/comparison-of-triple-site-ventricular-pacing-versus-conventional-cardiac-resynchronization-therapy-in-patients-with-systolic-heart-failure-a-meta-analysis-of-randomized-and-observational-studies
#2
Baowei Zhang, Junfang Guo, Guohui Zhang
Background: Conventional cardiac resynchronization therapy (CRT, Bi-V) is associated with no response in about 40% patients due to an insufficient resynchronization. Some studies showed triple-site ventricular (Tri-V) pacing had greater benefits compared with Bi-V pacing, but the results of these studies were conflicting. We hypothesized that Tri-V pacing had greater benefits on long-term outcomes compared with Bi-V pacing in patients with heart failure. Methods: PubMed, EMBASE, and the Cochrane Library were searched for clinical studies with related outcomes...
February 2018: Journal of Arrhythmia
https://www.readbyqxmd.com/read/29628471/a-case-of-a-cardiac-resynchronization-therapy-defibrillator-exhibiting-a-lower-and-alternately-variable-basic-rate
#3
Keigo Iwazaki, Toshiya Kojima, Takahide Murasawa, Jun Yokota, Hikaru Tanimoto, Jun Matsuda, Nobuaki Fukuma, Takumi Matsubara, Yu Shimizu, Gaku Oguri, Eriko Hasumi, Hitoshi Kubo, Kyungho Chang, Katsuhito Fujiu, Issei Komuro
A cardiac resynchronization therapy defibrillator (CRT-D) (Medtronic Inc. Protecta XT) was implanted in a 67-year-old man who had cardiac sarcoidosis with extremely low cardiac function. He had ventricular tachycardia which was controlled by catheter ablation, medication and pacing. The programmed mode was DDI, lower rate was 90 beats/minute, paced AV delay was 150 ms, and the noncompetitive atrial pacing (NCAP) function was programmed as 300 ms.After his admission for pneumonia and heart failure, we changed his DDI mode to a DDD mode because he had atrial tachycardia, which led to inadequate bi-ventricular pacing...
April 6, 2018: International Heart Journal
https://www.readbyqxmd.com/read/29608497/his-bundle-pacing-hemodynamics-and-clinical-outcomes
#4
Brijesh Patel, Jalaj Garg, Rahul Chaudhary, Naveen Sablani, Rahul Gupta, Mahek Shah, Talha Nazir, Babak Bozorgnia, Andrea Natale
From 1993 to 2009, nearly 2.9 million pacemakers were implanted in the United States; the majority of which were dual chamber pacemakers. One of the major physiologic advantages of dual chamber pacing over single chamber ventricular pacing is atrioventricular synchrony, which prevents the pacemaker syndrome. However, patients who are pacemaker dependent or use right ventricle (RV) apical pacing more than 40% of the time are at a risk of developing heart failure from electromechanical dyssynchrony. Studies have also shown that RV pacing results in non-physiological activation of the left ventricle, leading to adverse clinical outcomes...
March 30, 2018: Cardiology in Review
https://www.readbyqxmd.com/read/29529181/estimation-of-myocardial-work-from-pressure-strain-loops-analysis-an-experimental-evaluation
#5
Arnaud Hubert, Virginie Le Rolle, Christophe Leclercq, Elena Galli, Eigil Samset, Cyrille Casset, Philippe Mabo, Alfredo Hernandez, Erwan Donal
Purpose: The area of left ventricular (LV) pressure-strain loop (PSL) is used as an index of regional myocardial work. The purpose of the present work is to compare the main segmental PSL markers and the derived global work indices, when they are calculated using an estimated pressure signal or an observed pressure signal. Methods and results: In nine patients implanted with a bi-ventricular pace-maker (CRT), LV pressure was invasively measured in five conditions: CRT-off, LV-pacing, right ventricular-pacing and two different CRT-pacing...
February 26, 2018: European Heart Journal Cardiovascular Imaging
https://www.readbyqxmd.com/read/29315424/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#6
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/29216239/effects-of-early-afterdepolarizations-on-excitation-patterns-in-an-accurate-model-of-the-human-ventricles
#7
Enid Van Nieuwenhuyse, Gunnar Seemann, Alexander V Panfilov, Nele Vandersickel
Early Afterdepolarizations, EADs, are defined as the reversal of the action potential before completion of the repolarization phase, which can result in ectopic beats. However, the series of mechanisms of EADs leading to these ectopic beats and related cardiac arrhythmias are not well understood. Therefore, we aimed to investigate the influence of this single cell behavior on the whole heart level. For this study we used a modified version of the Ten Tusscher-Panfilov model of human ventricular cells (TP06) which we implemented in a 3D ventricle model including realistic fiber orientations...
2017: PloS One
https://www.readbyqxmd.com/read/28611676/autonomic-modulation-in-patients-with-heart-failure-increases-beat-to-beat-variability-of-ventricular-action-potential-duration
#8
Bradley Porter, Martin J Bishop, Simon Claridge, Jonathan Behar, Benjamin J Sieniewicz, Jessica Webb, Justin Gould, Mark O'Neill, Christopher A Rinaldi, Reza Razavi, Jaswinder S Gill, Peter Taggart
Background: Exaggerated beat-to-beat variability of ventricular action potential duration (APD) is linked to arrhythmogenesis. Sympathetic stimulation has been shown to increase QT interval variability, but its effect on ventricular APD in humans has not been determined. Methods and Results: Eleven heart failure patients with implanted bi-ventricular pacing devices had activation-recovery intervals (ARI, surrogate for APD) recorded from LV epicardial electrodes under constant RV pacing. Sympathetic activity was increased using a standard autonomic challenge (Valsalva) and baroreceptor indices were applied to determine changes in sympathetic stimulation...
2017: Frontiers in Physiology
https://www.readbyqxmd.com/read/28416247/adaptive-crt-in-patients-with-normal-av-conduction-and-left-bundle-branch-block-does-qrs-duration-matter
#9
RANDOMIZED CONTROLLED TRIAL
Hiro Yamasaki, Daniel Lustgarten, Jeffrey Cerkvenik, David Birnie, Maurizio Gasparini, Kathy Lia-Fun Lee, Yukio Sekiguchi, Niraj Varma, Bernd Lemke, Randall C Starling, Kazutaka Aonuma
BACKGROUND: Adaptive cardiac resynchronization therapy (aCRT) is a dynamic optimization algorithm which paces only the left ventricle (LV) when atrio-ventricular (AV) conduction is normal, thus reducing right ventricular (RV) pacing. However, the impact of QRS duration on aCRT efficacy remains uncertain. We examined whether QRS duration impacts aCRT effectiveness in patients with left bundle branch block (LBBB) and preserved AV conduction. METHODS: Randomized patients in the Adaptive CRT trial, which enrolled NYHA III/IV patients, were used in this analysis...
August 1, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28407744/global-bi-ventricular-endocardial-distribution-of-activation-rate-during-long-duration-ventricular-fibrillation-in-normal-and-heart-failure-canines
#10
Qingzhi Luo, Qi Jin, Ning Zhang, Yanxin Han, Yilong Wang, Shangwei Huang, Changjian Lin, Tianyou Ling, Kang Chen, Wenqi Pan, Liqun Wu
BACKGROUND: The objective of this study was to detect differences in the distribution of the left and right ventricle (LV & RV) activation rate (AR) during short-duration ventricular fibrillation (SDVF, <1 min) and long-duration ventricular fibrillation VF (LDVF, >1 min) in normal and heart failure (HF) canine hearts. METHODS: Ventricular fibrillation (VF) was electrically induced in six healthy dogs (control group) and six dogs with right ventricular pacing-induced congestive HF (HF group)...
April 13, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28284503/renal-denervation-regulates-the-atrial-arrhythmogenic-substrates-through-reverse-structural-remodeling-in-heart-failure-rabbit-model
#11
Shinya Yamada, Li-Wei Lo, Yu-Hui Chou, Wei-Lun Lin, Shih-Lin Chang, Yenn-Jiang Lin, Shih-Ann Chen
BACKGROUND: Heart failure (HF) causes atrial remodeling and increases the incidence of atrial fibrillation (AF). Renal denervation (RDN) has been shown to decrease the development of AF. This study aimed to identify the effects of RDN on the atrial arrhythmogenic substrates in HF. METHODS: Rabbits were classified into four groups: control (n=9), RDN (n=10), HF (n=6) and HF-RDN (n=9). Surgical and chemical RDN was approached through bilateral retroperitoneal flank incisions in RDN and HF-RDN...
May 15, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28104482/device-pacing-diagnostics-overestimate-effective-cardiac-resynchronization-therapy-pacing-results-of-the-holter-for-efficacy-analysis-of-crt-ol%C3%A3-crt-study
#12
MULTICENTER STUDY
Antonio Hernández-Madrid, Domenico Facchin, Ruth Nicholson Klepfer, Subham Ghosh, Roberto Matía, Javier Moreno, Alessandro Locatelli
BACKGROUND: A high percentage of biventricular (BiV) or left ventricular (LV) pacing in cardiac resynchronization therapy (CRT) devices has been associated with superior clinical outcomes. However, the percent ventricular (%V) pacing reported by CRT devices simply indicates the number of paces the device has delivered and not the proportion of pacing that has captured the LV effectively. OBJECTIVE: The purpose of this study was to determine whether a beat-by-beat evaluation of effective pacing would provide a more accurate evaluation of CRT delivery...
April 2017: Heart Rhythm: the Official Journal of the Heart Rhythm Society
https://www.readbyqxmd.com/read/28011796/cardiac-resynchronization-therapy-in-patients-with-end-stage-hypertrophic-cardiomyopathy
#13
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...
December 23, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28000309/utilization-of-permanent-his-bundle-pacing-for-management-of-proarrhythmia-related-to-biventricular-pacing
#14
Aamir Sofi, Pugazhendhi Vijayaraman, S Serge Barold, Bengt Herweg
Biventricular pacing has occasionally been associated with ventricular proarrhythmia, which at times can be refractory to conventional antiarrhythmic drug therapy and ablative intervention. Recently, permanent His-bundle pacing has emerged as a reasonable alternative to right ventricular and biventricular pacing. In addition, by maintaining the physiologic pattern of ventricular electrical activation, it is less likely to be arrhythmogenic. We report the use of permanent His-bundle pacing to manage ventricular proarrhythmia that developed after initiation of biventricular pacing and was unresponsive to antiarrhythmic and ablative therapy...
April 2017: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/27255170/triple-site-pacing-for-cardiac-resynchronization-in-permanent-atrial-fibrillation-acute-phase-results-from-a-prospective-observational-study
#15
Pedro Marques, Miguel Nobre Menezes, Gustavo Lima da Silva, Ana Bernardes, Andreia Magalhães, Nuno Cortez-Dias, Luís Carpinteiro, João de Sousa, Fausto J Pinto
INTRODUCTION AND AIM: Multi-site pacing is emerging as a new method for improving response to cardiac resynchronization therapy (CRT), but has been little studied, especially in patients with atrial fibrillation. We aimed to assess the effects of triple-site (Tri-V) vs. biventricular (Bi-V) pacing on hemodynamics and QRS duration. METHODS: This was a prospective observational study of patients with permanent atrial fibrillation and ejection fraction <40% undergoing CRT implantation (n=40)...
June 2016: Portuguese Journal of Cardiology: An Official Journal of the Portuguese Society of Cardiology
https://www.readbyqxmd.com/read/26771573/left-atrial-size-and-function-in-a-canine-model-of-chronic-atrial-fibrillation-and-heart-failure
#16
Adam Goldberg, Kenya Kusunose, Salima Qamruddin, L Leonardo Rodriguez, Todor N Mazgalev, Brian P Griffin, David R Van Wagoner, Youhua Zhang, Zoran B Popović
BACKGROUND: Our aim was to assess how atrial fibrillation (AF) induction, chronicity, and RR interval irregularity affect left atrial (LA) function and size in the setting of underlying heart failure (HF), and to determine whether AF effects can be mitigated by vagal nerve stimulation (VNS). METHODS: HF was induced by 4-weeks of rapid ventricular pacing in 24 dogs. Subsequently, AF was induced and maintained by atrial pacing at 600 bpm. Dogs were randomized into control (n = 9) and VNS (n = 15) groups...
2016: PloS One
https://www.readbyqxmd.com/read/26748729/generating-purkinje-networks-in-the-human-heart
#17
Francisco Sahli Costabal, Daniel E Hurtado, Ellen Kuhl
The Purkinje network is an integral part of the excitation system in the human heart. Yet, to date, there is no in vivo imaging technique to accurately reconstruct its geometry and structure. Computational modeling of the Purkinje network is increasingly recognized as an alternative strategy to visualize, simulate, and understand the role of the Purkinje system. However, most computational models either have to be generated manually, or fail to smoothly cover the irregular surfaces inside the left and right ventricles...
August 16, 2016: Journal of Biomechanics
https://www.readbyqxmd.com/read/26736775/multi-modal-data-fusion-for-cardiac-resynchronization-therapy-planning-and-assistance
#18
Sophie Bruge, Antoine Simon, Mathieu Lederlin, Julian Betancur, Alfredo Hernandez, Erwan Donal, Christophe Leclercq, Mireille Garreau
Cardiac Resynchronization Therapy (CRT) has been validated as an efficient treatment for selected patients suffering from heart failure with cardiac dyssynchrony. In case of bi-ventricular stimulation, the response to the therapy may be improved by an optimal choice of the left ventricle (LV) pacing sites. The characterization of LV properties to select the best candidate sites and to precise their access modes would be useful for the clinician in pre- and per-operative stages. For that purpose, we propose a new pre-operative analysis solution integrating previously developed multi-modal data registration methods and a new segmentation process of their coronary venous access...
2015: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/26402340/flecainide-attenuates-rate-adaptation-of-ventricular-repolarization-in-guinea-pig-heart
#19
Oleg E Osadchii
OBJECTIVES: Flecainide is class Ic antiarrhythmic agent that was found to increase the risk of sudden cardiac death. Arrhythmic responses to flecainide could be precipitated by exercise, suggesting a role played by inappropriate rate adaptation of ventricular repolarization. This study therefore examined flecainide effect on adaptation of the QT interval and ventricular action potential duration (APD) to abrupt reductions of the cardiac cycle length. DESIGN: ECG and ventricular epicardial and endocardial monophasic APD were recorded in isolated, perfused guinea-pig heart preparations upon a sustained cardiac acceleration (rapid pacing for 30 s), and following a single perturbation of the cycle length evoked by extrasystolic stimulation...
2016: Scandinavian Cardiovascular Journal: SCJ
https://www.readbyqxmd.com/read/26082366/-role-of-cyclic-adenosine-monophosphate-response-element-binding-protein-in-ventricular-pacing-induced-cardiac-electrical-remodeling-in-a-canine-model
#20
Xuesi Chen, Xingxing Chen, Junhua Cheng, Jun Hong, Cheng Zheng, Jinglin Zhao, Jin Li, Jiafeng Lin
OBJECTIVE: This project is designed to explore the potential role of cyclic adenosine monophosphate (cAMP) response element binding protein (CREB) in cardiac electrical remodeling induced by pacing at different ventricular positions in dogs. METHODS: An animal model by implanting the pacemakers in beagles was established. According to the different pacing positions, the animals were divided into 4 groups:conditional control group (n=6), left ventricle pacing group (n=6), right ventricle pacing group (n=6) and bi-ventricle pacing group (n=6)...
April 2015: Zhonghua Xin Xue Guan Bing za Zhi
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