EFFICACY OF CARDIAC RESYNCHRONIZATION THERAPY IN HEART FAILURE AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 37-43
Author(s):  
Anh Tien Hoang ◽  
Anh Tuan Ho ◽  
Van Minh Huynh ◽  
Van Dien Nguyen
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Nyha Class ◽  
Pacemaker Implantation ◽  
University Hospital ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
Ventricular Dyssynchrony

Background: Cardiac resynchronization therapy is one of new methods used to treating patients with heart failure who have ventricular dyssynchrony. Objectives: 1. To study clinical, laboratory characteristis of heart failure patients with ventricular dyssynchrony. 2. To study the efficacy of cardiac resynchronization therapy in treating such group of patients. Materials and method: From February 2009 to February 2011, we implanted biventricular pacemakers at Hue University Hospital for 15 patients who had NYHA class III and IV heart failure and had been treated with optimal medical therapy, LVEF ≤35%, QRS duration ≥ 120ms. Result: 14/15 cases succeeded, cardiac function improved after 1 year follow – up of biventricular pacemaker implantation, with significantly increased EF, decreased LVIDd, PAPs. At the cut off of EF <30%, the rate of patients with EF <30% declined chronologically (1 year of follow – up). Functional symptoms improved overtly according to NYHA class. The choice of A-V delay and V-V delay is very important. Optimal A-V delay and V-V delay after programming were (152±8.33)ms and (26.33±6.31)ms, retrospectively. Conclusion: Cardiac resynchronization therapy is effective in improving heart failure patients with ventricular dyssynchronization.

scholarly journals P440One-year outcomes of cardiac resynchronization therapy in non-ambulatory NYHA class IV heart failure patients

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii96-iii96
Author(s):  
G. Loughlin ◽  
E. Gonzalez-Torrecilla ◽  
R. Peinado ◽  
C. Alvarez ◽  
P. Avila ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Nyha Class ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
Class Iv

Time trends in sudden cardiac death risk in heart failure patients with cardiac resynchronization therapy: a systematic review

2019 ◽  
Vol 41 (21) ◽  
pp. 1976-1986 ◽  
Author(s):  
Sérgio Barra ◽  
Rui Providência ◽  
Kumar Narayanan ◽  
Serge Boveda ◽  
Rudolf Duehmke ◽  
...  
Keyword(s):  
Heart Failure ◽  
Sudden Cardiac Death ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Death ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
The Difference ◽  
Over Time

Abstract Aims While data from randomized trials suggest a declining incidence of sudden cardiac death (SCD) among heart failure patients, the extent to which such a trend is present among patients with cardiac resynchronization therapy (CRT) has not been evaluated. We therefore assessed changes in SCD incidence, and associated factors, in CRT recipients over the last 20 years. Methods and results Literature search from inception to 30 April 2018 for observational and randomized studies involving CRT patients, with or without defibrillator, providing specific cause-of-death data. Sudden cardiac death was the primary endpoint. For each study, rate of SCD per 1000 patient-years of follow-up was calculated. Trend line graphs were subsequently constructed to assess change in SCD rates over time, which were further analysed by device type, patient characteristics, and medical therapy. Fifty-three studies, comprising 22 351 patients with 60 879 patient-years of follow-up and a total of 585 SCD, were included. There was a gradual decrease in SCD rates since the early 2000s in both randomized and observational studies, with rates falling more than four-fold. The rate of decline in SCD was steeper than that of all-cause mortality, and accordingly, the proportion of deaths which were due to SCD declined over the years. The magnitude of absolute decline in SCD was more prominent among CRT-pacemaker (CRT-P) patients compared to those receiving CRT-defibrillator (CRT-D), with the difference in SCD rates between CRT-P and CRT-D decreasing considerably over time. There was a progressive increase in age, use of beta-blockers, and left ventricular ejection fraction, and conversely, a decrease in QRS duration and antiarrhythmic drug use. Conclusion Sudden cardiac death rates have progressively declined in the CRT heart failure population over time, with the difference between CRT-D vs. CRT-P recipients narrowing considerably.

P3807Impact of unipolar vs bipolar left ventricular pacing using a quadripolar lead on heart failure hospitalization in patients undergoing cardiac resynchronization therapy

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
S Mittal ◽  
T Stivland ◽  
N Wold ◽  
E Hammill ◽  
K M Stein
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Nyha Class ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Study Cohort ◽  
Resynchronization Therapy ◽  
Heart Failure Hospitalization ◽  
Lead Location

Abstract Background Unipolar (uni) pacing from a bipolar left ventricular (LV) pacing lead in cardiac resynchronization therapy (CRT) patients (pts) has been associated with worse outcomes than bipolar (bi) pacing (MADIT CRT and ALTITUDE analyses). However, it is unknown whether the same is true with quadripolar LV pacing leads. Purpose To determine whether there is a difference in heart failure hospitalization (HFH) following CRT implantation in pts undergoing uni vs. bi LV pacing. Methods All pts enrolled in the NAVIGATE study were implanted with a CRT-D (RESONATE, Boston Scientific) using a quadripolar LV lead (ACUITY X4 Spiral Long, Spiral Short, or Straight). Pts were followed, and data collected on HFH and mortality. Vectors were programmed at the discretion of the implanter. Outcomes were adjusted for age, gender, NYHA class, ischemic etiology, conduction disorder pattern, EF, LV lead location, and LV lead shape. Results The study cohort included 2080 pts; 1781 pts had bi and 299 pts had uni LV pacing. Bi LV had higher % female, NYHA II/III, non-ischemic, LBBB, spiral shape, lateral and apical locations. During follow-up, the adjusted likelihood of HFH was significantly lower in pts undergoing bi LV pacing (HR 0.75, 0.58–0.97, p=0.027, Figure). Mortality was similar between the two groups. Conclusions In this large prospective study, uni LV pacing was associated with significantly greater likelihood of need for HFH during a 4-year follow-up period. These data suggest that routine programming in a bi configuration may be better for post-CRT pts. However, further study is needed to confirm causality and mechanism of this finding.

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