QRS duration and clinical outcomes in heart failure patients receiving cardiac resynchronization therapy

2013 ◽  
Vol 34 (suppl 1) ◽  
pp. P3179-P3179
Author(s):  
D. Konstantinou ◽  
K. Guha ◽  
C. Cook ◽  
R. Sharma
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Clinical Outcomes ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
Qrs Duration

scholarly journals Cardiac index in atrio- and interventricular delay optimized cardiac resynchronization therapy and cardiac contractility modulation

2015 ◽  
Vol 1 (1) ◽  
pp. 89-91 ◽  
Author(s):  
J. Tumampos ◽  
N. Wulf ◽  
H. Kühnert ◽  
O. Solbrig ◽  
J. Querengässer ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Index ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Contractility ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Cardiac Contractility Modulation ◽  
Heart Failure Patients ◽  
Qrs Duration

AbstractCardiac resynchronization therapy (CRT) is an established therapy for heart failure patients and improves quality of life in patients with sinus rhythm, reduced left ventricular ejection fraction (LVEF), left bundle branch block and wide QRS duration. Since approximately sixty percent of heart failure patients have a normal QRS duration they do not benefit or respond to the CRT. Cardiac contractility modulation (CCM) releases nonexcitatoy impulses during the absolute refractory period in order to enhance the strength of the left ventricular contraction. The aim of the investigation was to evaluate differences in cardiac index between optimized and nonoptimized CRT and CCM devices versus standard values. Impedance cardiography, a noninvasive method was used to measure cardiac index (CI), a useful parameter which describes the blood volume during one minutes heart pumps related to the body surface. CRT patients indicate an increase of 39.74 percent and CCM patients an improvement of 21.89 percent more cardiac index with an optimized device.

scholarly journals Effects of Adaptive Cardiac Resynchronization Therapy With Left-Bundle-Branch Area Pacing and Coronary Sinus Pacing

2021 ◽  
Author(s):  
Xiang-Fei Feng ◽  
Ren-Hua Chen ◽  
Rui Zhang ◽  
Yi-Chi Yu ◽  
Bo Liu ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Statistical Significance ◽  
Cardiac Resynchronization ◽  
Lv Function ◽  
Resynchronization Therapy ◽  
Reduced Ejection Fraction ◽  
Heart Failure Patients ◽  
Av Conduction ◽  
Qrs Duration

Abstract Adaptive cardiac resynchronization therapy (aCRT) is associated with improved clinical outcomes. Left bundle branch area pacing (LBBAP) has shown encouraging results as an alternative option for CRT. In this study, we observed the clinical and echocardiographic outcome of LBB-optimized aCRT in combination with synchronized LV pacing (LOT-aCRT) in heart failure patients with reduced ejection fraction and LBBB. Heart failure patients with preserved AV conduction and LBBB morphology, who underwent aCRT from February 1, 2019, to September 30, 2020 were included. The eligible patients with or without LBBAP were divided into LOT-aCRT group or BV-CRT group. In LOT-aCRT group, the CS lead was connected to the pace-sensing portion of the RV port, and the LBBAP lead was connected to the LV port. Seventeen patients were enrolled in this study (8 cases in LOT-aCRT group, 9 cases in BV-CRT group). Patients were matched for ischemic cardiomyopathy (ICM) at baseline (5 cases vs. 4 cases). QRS duration (QRSd) via BVP was narrowed from 158.0 ± 13.0 ms at baseline to 132.0 ± 4.5 ms in LOT-aCRT group (P=0.019), and further narrowed to 123.0 ± 5.7 ms (P < 0.01) via LBBAP. However, LOT-aCRT resulted in further reduction of the QRSd (121.0 ± 3.8 ms), but no statistical significance (P > 0.05). In BV-CRT group, BVP resulted in significant reduction of the QRSd from 176.7 ±19.7 ms at baseline to 143.3 ±8.2 ms (P=0.011). However, compared with LOT-aCRT, BVP has no any advantage in reducing QRSd (P > 0.05). During follow-up, patients in LOT-aCRT group showed significant improvement in LVEF and NT-proBNP levels (P < 0.01), while patients in BV-CRT group showed non-significant changes in these parameters (P >0.05). The study demonstrates that LOT-aCRT is clinically feasible in patients with systolic HF and LBBB. LOT-aCRT was associated with significant narrowing of the QRSd and improvement in LV function, especially in patients with ICM.

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