Search results for "Cardiac resynchronization"
showing 10 items of 28 documents
Clinical Benefit of Cardiac Resynchronization Therapy With a Defibrillator in Patients With an Ejection Fraction > 35% Estimated by Cardiac Magnet…
2014
A B S T R A C T Introduction and objectives: Cardiac resynchronization therapy with a defibrillator prolongs survival and improves quality of life in advanced heart failure. Traditionally, patients with ejection fraction > 35 estimated by echocardiography have been excluded. We assessed the prognostic impact of this therapy in a group of patients with severely depressed systolic function as assessed by echocardiography but with an ejection fraction > 35% as assessed by cardiac magnetic resonance. Methods: We analyzed consecutive patients admitted for decompensated heart failure between 2004 and 2011. The patients were in functional class II-IV, with a QRS to 120 ms, ejection fraction 35% es…
Mortality after cardioverter-defibrillator replacement: Results of the DECODE survival score index
2020
Background Device replacement is the ideal time to reassess health care goals regarding continuing implantable cardioverter-defibrillator (ICD) therapy. Only few data are available on the decision making at this time. Objectives The goals of this study were to identify factors associated with poor prognosis at the time of ICD replacement and to develop a prognostic index able to stratify those patients at risk of dying early. Methods DEtect long-term COmplications after implantable cardioverter-DEfibrillator replacement (DECODE) was a prospective, single-arm, multicenter cohort study aimed at estimating long-term complications in a large population of patients who underwent ICD/cardiac resy…
Sex-Specific Ventricular Arrhythmias and Mortality in Cardiac Resynchronization Therapy Recipients
2021
OBJECTIVES The study goal was to examine whether there are sex-related differences in the incidence of ventricular arrhythmias and mortality in CRT-defibrillator (CRT-D) recipients. BACKGROUND Few studies have evaluated sex-related benefits of cardiac resynchronization therapy (CRT). Moreover, data on sex-related differences in the occurrence of ventricular tachyarrhythmias in this population are limited. METHODS A multicenter retrospective study was conducted in 460 patients (355 male subjects and 105 female subjects) from the UMBRELLA (Incidence of Arrhythmia in Spanish Population With a Medtronic Implantable Cardiac Defibrillator Implant) national registry. Patients were followed up thro…
Magnitude of QRS duration reduction after biventricular pacing identifies responders to cardiac resynchronization therapy
2016
Background Several studies have investigated the association between native QRS duration (QRSd) or QRS narrowing and response to biventricular pacing. However, their results have been conflicting. The aim of our study was to determine the association between the relative change in QRS narrowing index (QI) and clinical outcome and prognosis in patients who undergo cardiac resynchronization therapy (CRT) implantation. Methods and results We included 311 patients in whom a CRT device was implanted in accordance with current guidelines for CRT. On implantation, the native QRS, the QRSd and the QI during CRT were measured. After 6 months, 220 (71%) patients showed a 10% reduction in LVESV. The m…
Predictive analysis of Cardiac Resynchronization Therapy response by means of the ECG
2016
Aims: Cardiac Resynchronization Therapy (CRT) is an effective treatment for heart failure patients with moderate to severe symptoms. Unfortunately, a significant proportion of patients (up to 35%) do not respond to CRT (patients called "non-responders"). This results in a large cost-effectiveness relation for heart failure treatment. This study aims to assess the prediction response to CRT by means of analysing the ECG. Methods: We retrospectively analysed the surface ECG and QRS previous to CRT implantation in 45 consecutive patients with dilated (27) or ischemic (18) cardiomyopathy. We extracted the QRS and then processed a measure of energy of a discrete version of the Stockwell Transfor…
Active-fixation coronary sinus pacing lead extraction: A hybrid approach
2012
Cardiac resynchronization therapy (CRT) can be considered as the standard treatment for patients suffering from heart failure (NYHA III–IV), severely reduced left ventricular (LV) function, and wide QRS complexes. Over the past years, the lead systems used to stimulate the left ventricle have evolved technically from epicardial approaches to a transvenous access accompanied by a significant reduction of procedure-related complication rates [1]. However, even today, LV dislodgement rates ranging 5–10% and the instability of thresholds over time remain the greatest challenges with transvenous LV leads in CRT. Therefore, a special LV lead utilizing active fixation (the Attain StarFix® active f…
Device Therapy for Rate Control: Pacing, Resynchronisation and AV Node Ablation
2017
Atrioventricular node ablation (AVNA) is generally reserved for patients whose atrial fibrillation (AF) is refractory all other therapeutic options, since the recipients will often become pacemaker dependent. In such patients, this approach may prove particularly useful, especially if a tachycardia-induced cardiomyopathy is suspected. Historically, an "ablate and pace" approach has involved AVNA and right ventricular pacing, with or without an atrial lead. There is also an evolving role for atrioventricular node ablation in patients with AF who require cardiac resynchronisation therapy for treatment of systolic heart failure. A mortality benefit over pharmacotherapy has been demonstrated in…
A possible easy way to predict response to cardiac resynchronization therapy: The role of QRS Index
2023
Background: Some studies have evaluated the role of QRS duration (QRSd) as predictor of response to Cardiac Resynchronization Therapy (CRT). However, their results are still not entirely clear. The goal of our study was to determine the correlation between the relative change in QRS narrowing index (QI) compared to clinical outcome and prognosis in patients who underwent CRT implantation. Methods: We collected clinical and echocardiographic data of 115 patients in whome a CRT device was implanted in accordance with current guidelines. QRS duration before and after CRT implantation and QI were measured. Results: After 6 months, a signifi cant improvement in all echocardiographic parameters w…
In-hospital and long-term prognosis in patients after implantation of implantable cardioverter-defibrillators and cardiac resynchronization therapy: …
2018
Introduction During the last 20 years, there has been a considerable increase in the number of implanted implantable cardioverter‑defibrillator (ICD) and cardiac resynchronization therapy (CRT) devices. However, there have been only single reports on clinical events, including rehospitalizations, in the long‑term follow‑up. Objectives We analyzed the baseline clinical characteristics, medical procedures used, and complications of patients with implantation of an ICD or CRT device. Moreover, we analyzed the causes of rehospitalization and the types of treatment used in the 12‑month follow‑up. Patients and methods Out of 1 208 440 hospitalizations of patients with cardiovascular diseases incl…
Therapeutic decision-making for patients with fluctuating mitral regurgitation
2015
Mitral regurgitation (MR) is a common, progressive, and difficult-to-manage disease. MR is dynamic in nature, with physiological fluctuations occurring in response to various stimuli such as exercise and ischaemia, which can precipitate the development of symptoms and subsequent cardiac events. In both chronic primary and secondary MR, the dynamic behaviour of MR can be reliably examined during stress echocardiography. Dynamic fluctuation of MR can also have prognostic value; patients with a marked increase in regurgitant volume or who exhibit increased systolic pulmonary artery pressure during exercise have lower symptom-free survival than those who do not experience significant changes in…