Search results for "cardiac resynchronization therapy"

Optimization of Lead Placement in the Right Ventricle During Cardiac Resynchronization Therapy. A Simulation Study

2019

[EN] Patients suffering from heart failure and left bundle branch block show electrical ventricular dyssynchrony causing an abnormal blood pumping. Cardiac resynchronization therapy (CRT) is recommended for these patients. Patients with positive therapy response normally present QRS shortening and an increased left ventricle (LV) ejection fraction. However, around one third do not respond favorably. Therefore, optimal location of pacing leads, timing delays between leads and/or choosing related biomarkers is crucial to achieve the best possible degree of ventricular synchrony during CRT application. In this study, computational modeling is used to predict the optimal location and delay of p…

Can Ventricular Resynchronization Reduce Atrial Fibrillation Recurrences?

2003

In recent years a new pacing therapy has been proposed for patients affected by heart failure (HF) in order to reduce inter- [1,2], intra- [3,4], and atrioventricular [5] (AV) dyssynchrony. Cardiac resynchronization therapy (CRT) has the goal of correcting these hemodynamic disorders, thus improving left ventricular (LV) performance. The benefits of CRT have been evaluated in a series of clinical trials [6-10].

A case of arrhythmogenic right ventricular cardiomyopathy without ventricular arrhythmias

2014

Abstract We submit a case report of a 21-year-old man admitted to our emergency room for acute right heart failure. Arrhythmogenic right ventricular cardiomyopathy (ARVC) was diagnosed but ventricular arrhythmias have never been detected. On the basis of the diagnosis of ARVC and for the frequent episodes of symptomatic bradycardia, the patient underwent implantation of a biventricular defibrillator (CRT-D). In ARVC symptoms usually appear between the ages of 30–50. Especially in young patients the most common clinical presentation of ARVC are palpitations and syncope due to ventricular tachycardia with left bundle branch morphology. In cases of older patients in whom the disease has been d…

Focus sui non responder alla terapia di resincronizzazione cardiaca: orizzonti e prospettive

2017

Cardiac resynchronization therapy (CRT) has been shown as a successful strategy in the treatment of patients with heart failure and electrical dyssincrony. However, a significant proportion of implanted patients fails to respond sufficiently or in a predictable manner. Consequently, non response to CRT remains a valuable problem in clinical practice. In order to improve CRT response and long-term clinical benefits, the proper evaluation of patient's global frialty, the technology improvement, the multimodality imaging approach and the use of simple and low cost electrographic parameters (to verify effective biventricular capture and QRS narrowing) could play a important role. Therefore, the…

Prediction of CRT Activation Sequence by Personalization of Biventricular Models from Electroanatomical Maps

2020

[EN] Optimization of lead placement and interventricular delay settings in patients under cardiac resynchronization therapy is a complex task that might benefit from prior information based on models. Biophysical models can be used to predict the sequence of electrical heart activation in a patient given a set of parameters which should be personalized to the patient. In this paper, we use electroanatomical maps to personalize the endocardial activation of the right ventricle, and the different tissue conductivities in a pig model with left bundle branch block, to reproduce personalized biventricular activations. Following, we tested the personalized heart model by virtually simulating card…

Three-dimensional cardiac computational modelling: methods, features and applications

2015

[EN] The combination of computational models and biophysical simulations can help to interpret an array of experimental data and contribute to the understanding, diagnosis and treatment of complex diseases such as cardiac arrhythmias. For this reason, three-dimensional (3D) cardiac computational modelling is currently a rising field of research. The advance of medical imaging technology over the last decades has allowed the evolution from generic to patient-specific 3D cardiac models that faithfully represent the anatomy and different cardiac features of a given alive subject. Here we analyse sixty representative 3D cardiac computational models developed and published during the last fifty …

Meshless Electrophysiological Modeling of Cardiac Resynchronization Therapy—Benchmark Analysis with Finite-Element Methods in Experimental Data

2022

Computational models of cardiac electrophysiology are promising tools for reducing the rates of non-response patients suitable for cardiac resynchronization therapy (CRT) by optimizing electrode placement. The majority of computational models in the literature are mesh-based, primarily using the finite element method (FEM). The generation of patient-specific cardiac meshes has traditionally been a tedious task requiring manual intervention and hindering the modeling of a large number of cases. Meshless models can be a valid alternative due to their mesh quality independence. The organization of challenges such as the CRT-EPiggy19, providing unique experimental data as open access, enables b…

Device-Therapie nach akutem Koronarsyndrom

2014

AV-Blocke sind beim akuten Koronarsyndroms selten. Nur wenige Patienten benotigen eine Schrittmacherimplantation. Besonders beim Hinterwandinfarkt ist die Prognose gut. Die Haufigkeit anhaltender AV-Blockierungen hat durch die Akut-PTCA abgenommen. Ventrikulare Tachyarrhythmien sind in der Akutphase des Infarktes haufig. Treten sie als anhaltende Kammertachykardien oder Kammerflimmern > 48 Stunden nach Infarkt auf, konnen sie eine Indikation zur sekundarprophylaktischen ICD-Implantation darstellen. Primarprophylaktisch sollte ein Defibrillator implantiert werden, wenn die LV-EF auch > 40 Tage nach Infarkt ≤ 35 % betragt. Ist fruh nach Infarkt eine Aggregatimplantation erforderlich, sollte b…

The importance of being “responder” in cardiac resynchronization therapy

2016

Is there a right place to pace the right ventricle? Evaluation of apical and septal positions in a pacemaker population: Study protocol for a prospec…

2014

Abstract Introduction The main objective of research in pacemaker therapy has been to provide the best physiologic way to pace the heart. Despite the good results provided by right ventricular pacing minimization and by biventricular pacing in specific subsets of heart failure patients, these options present many limitations for standard pacemaker recipients. In these patients, pacing the right ventricle at alternative sites could result in a lower degree of left intraventricular dyssynchrony. Despite the lack of strong evidence and the difficulty in placing and accurately classifying the final lead position, pacing at alternative right ventricular sites seems to have become a standard proc…