MyMedR

The mortality analysis of primary prevention patients receiving a cardiac resynchronization defibrillator (CRT-D) or implantable cardioverter-defibrillator (ICD) according to guideline indications in the improve SCA study

Ching CK, Hsieh YC, Liu YB, Rodriguez DA, Kim YH, Joung B, et al.

J Cardiovasc Electrophysiol, 2021 08;32(8):2285-2294.

PMID: 34216069 DOI: 10.1111/jce.15149

BACKGROUND: In primary prevention (PP) patients the utilization of implantable cardioverter-defibrillators (ICD) and cardiac resynchronization therapy-defibrillators (CRT-D) remains low in many geographies, despite the proven mortality benefit.

PURPOSE: The objective of this analysis was to examine the mortality benefit in PP patients by guideline-indicated device type: ICD and CRT-D.

METHODS: Improve sudden cardiac arrest was a prospective, nonrandomized, nonblinded multicenter trial that enrolled patients from regions where ICD utilization is low. PP patient's CRT-D or ICD eligibility was based upon the 2008 ACC/AHA/HRS and 2006 ESC guidelines. Mortality was assessed according to guideline-indicated device type comparing implanted and nonimplanted patients. Cox proportional hazards methods were used, adjusting for known factors affecting mortality risk.

RESULTS: Among 2618 PP patients followed for a mean of 20.8 ± 10.8 months, 1073 were indicated for a CRT-D, and 1545 were indicated for an ICD. PP CRT-D-indicated patients who received CRT-D therapy had a 58% risk reduction in mortality compared with those without implant (adjusted hazard ratio [HR]: 0.42, 95% confidence interval [CI]: 0.28-0.61, p

Matched MeSH terms: Cardiac Resynchronization Therapy*; Cardiac Resynchronization Therapy Devices

Fulltext Performance of a novel left ventricular lead with short bipolar spacing for cardiac resynchronization therapy: primary results of the Attain Performa quadripolar left ventricular lead study

Crossley GH, Biffi M, Johnson B, Lin A, Gras D, Hussin A, et al.

Heart Rhythm, 2015 Apr;12(4):751-8.

PMID: 25533587 DOI: 10.1016/j.hrthm.2014.12.019

The Medtronic Attain Performa quadripolar leads provide 16 pacing vectors with steroid on every electrode. This includes a short bipolar configuration between the middle 2 electrodes.

Matched MeSH terms: Cardiac Resynchronization Therapy/adverse effects; Cardiac Resynchronization Therapy/methods; Cardiac Resynchronization Therapy Devices/adverse effects*

Novel active fixation mechanism permits precise placement of a left ventricular lead: early results from a multicenter clinical study

Yee R, Gadler F, Hussin A, Bin Omar R, Khaykin Y, Verma A, et al.

Heart Rhythm, 2014 Jul;11(7):1150-5.

PMID: 24801899 DOI: 10.1016/j.hrthm.2014.04.020

Left ventricular (LV) lead implantation for cardiac resynchronization therapy (CRT) is associated with lead dislodgement rates ranging from 3% to 10%, and some implant approaches to prevent dislodgement may contribute to suboptimal CRT response. We report our early human experience with an LV lead with a side helix for active fixation to the coronary vein wall.

Matched MeSH terms: Cardiac Resynchronization Therapy/adverse effects; Cardiac Resynchronization Therapy/methods*

Fulltext A comparison of long-term outcomes between narrow and broad QRS complex patients treated with cardiac resynchronization therapy

Yap LB, Nguyen ST, Qadir F, Ma SK, Muhammad Z, Koh KW, et al.

Acta Cardiol, 2016 Jun;71(3):323-30.

PMID: 27594128 DOI: 10.2143/AC.71.3.3152093

Matched MeSH terms: Cardiac Resynchronization Therapy/adverse effects*; Cardiac Resynchronization Therapy/methods

Fulltext Doppler echocardiography guided cardiac resynchronization therapy in heart failure

Oemar, Hamed, Abdulgani, Hafil Budianto

Medical Health Reviews, 2008;2008(1):17-28.

MyJurnal

Heart failure (HF) is a major burden in almost all countries. The prevalence of symptomatic HF is still high. Despite our best understanding of its pathophysiologic mechanisms and the recent advances in pharmacologic therapy, it remains a highmortality and morbidity disease. About 30-50% of patients with HF have concurrent electrical delay in the electrocardiogram (ECG), mainly in the form of LBBB.1 This kind of conduction delay commonly occurs in patients with idiopathic dilated cardiomyopathy and ischemic cardiomyopathy as well. The abnormality of left ventricle (LV) conduction will lead to a change in LV contraction pattern resulting dyssynchronized with right ventricle) contraction. Thus, a dyssynchronous LV contractile pattern usually manifested by late activation of the LV lateral wall which in turn impairs LV systolic function, reduces cardiac output, raises filling pressure and worsens mitral regurgitation2. Cardiac resynchronization therapy (CRT) improves cardiac function and exercise capacity leading to an improved survival in patients with advanced heart failure and ventricular conduction delay.3 The underlying mechanisms of these beneficial effects are not fully understood, but they appear to be related to a restored coordination of the left (LV) and right ventricular (RV) contraction and relaxation.4 These effects may directly lead to augmented contractility and reduction of LV filling pressures.5 Echocardiography has been widely used to identify patients who are candidates for CRT and to monitor the response in LV function at follow-up after device implantation. This review addresses the applications of CRT in patients with moderate– severe heart failure and the role of echocardiography in optimizing CRT including patient selection, risk and benefit of CRT and appropriate measures.

Matched MeSH terms: Cardiac Resynchronization Therapy

The clinical benefit of cardiac resynchronization therapy for narrow QRS compared to broad QRS complex patients

Yap LB, Qadir F, Nguyen ST, Ma SK, Koh KW, Muhammad Z, et al.

Int J Cardiol, 2015 Mar 15;183:178-9.

PMID: 25666128 DOI: 10.1016/j.ijcard.2015.01.042

Matched MeSH terms: Cardiac Resynchronization Therapy/methods*

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