scholarly journals Left ventricular‐only fusion pacing versus cardiac resynchronization therapy in heart failure patients: A randomized controlled trial

2021 ◽  
Author(s):  
Yangang Su ◽  
Wei Hua ◽  
Farong Shen ◽  
Jiangang Zou ◽  
Baopeng Tang ◽  
...  
Keyword(s):  
Heart Failure ◽  
Randomized Controlled Trial ◽  
Cardiac Resynchronization Therapy ◽  
Controlled Trial ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
Randomized Controlled

scholarly journals Adaptive Cardiac Resynchronization Therapy Effect on Electrical Dyssynchrony (aCRT-ELSYNC): a randomized controlled trial

2020 ◽  
Author(s):  
Kazi Haq ◽  
Nichole Rogovoy ◽  
Jason Thomas ◽  
Christopher Hamilton ◽  
Katherine Lutz ◽  
...  
Keyword(s):  
Randomized Controlled Trial ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Computed Tomography ◽  
Controlled Trial ◽  
Left Ventricular ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Randomized Controlled ◽  
Therapy Effect ◽  
Activation Times

Introduction: Adaptive cardiac resynchronization therapy (aCRT) is known to have clinical benefits over conventional CRT; however, their effects on the electrical dyssynchrony have not been compared. Methods: We conducted a double-blind, randomized controlled trial in patients receiving CRT for routine clinical indications. Participants underwent cardiac computed tomography and 128-electrodes body surface mapping. We measured electrical dyssynchrony on the epicardial surface using noninvasive electrocardiographic imaging (ECGI) before and 6 months post-CRT. Ventricular electrical uncoupling (VEU) was calculated as the difference between the mean left ventricular (LV) and right ventricular (RV) activation times. An electrical dyssynchrony index (EDI) was computed as the standard deviation of local epicardial activation times. Results: We randomized 27 participants (mean age 64 ± 12 y; 34% female; 53% ischemic cardiomyopathy; LV ejection fraction 28 ± 8%; QRS duration 155 ± 21 ms; strict left bundle branch block (LBBB) in 13%). In atypical LBBB (n=11;41%) with S-waves in V5-V6, conduction block occurred in the anterior RV, as opposed to the interventricular groove in those who met the strict LBBB criteria. As compared to baseline, VEU reduced post-CRT in aCRT (median reduction 18.9(interquartile range 4.3-29.2 ms; P=0.034), but not in conventional CRT (21.4(-30.0 to 49.9 ms; P=0.525) group. There were no differences in the degree of change in VEU and EDI indices between treatment groups. Conclusion: The effect of aCRT and conventional CRT on electrical dyssynchrony is largely similar. Further studies are needed to investigate if atypical LBBB with prominent S wave in V5-V6 responds to His bundle pacing

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.

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