Combined Minimally Invasive Pulmonary Vein Isolation, Left Atrial Appendage Excision and Cardiac Resynchronization Therapy for Heart Failure: Case Report

2005 ◽  
Vol 8 (4) ◽  
pp. E249-E252 ◽  
Author(s):  
Mariano E. Brizzio ◽  
Jose L. Navia ◽  
Fernando A. Atik ◽  
David Martin ◽  
A. Marc Gillinov ◽  
...  
Keyword(s):  
Heart Failure ◽  
Case Report ◽  
Minimally Invasive ◽  
Cardiac Resynchronization Therapy ◽  
Pulmonary Vein ◽  
Left Atrial ◽  
Left Atrial Appendage ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Case

scholarly journals Heart Failure Duration Combined with Left Atrial Dimension Predicts Super-Response and Long-Term Prognosis in Patients with Cardiac Resynchronization Therapy Implantation

2019 ◽  
Vol 2019 ◽  
pp. 1-8
Author(s):  
Zhinian Guo ◽  
Xiaoyan Liu ◽  
Chuan Liu ◽  
Jie Yang ◽  
Xiaofeng Cheng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Left Atrial ◽  
Cardiac Resynchronization ◽  
Reverse Remodeling ◽  
Resynchronization Therapy ◽  
End Point ◽  
Long Term Prognosis ◽  
Robust Prediction

Background. Response to cardiac resynchronization therapy (CRT) varies significantly among patients. This study aimed to identify baseline characteristics that could predict super-response to CRT and to evaluate the long-term prognosis in super-responders. Methods. We retrospectively reviewed the data of 73 consecutive patients who received CRT. Patients were considered as super-responders after 6-month follow-up when NYHA class reduction to I or II combined with left ventricular ejection fraction (LVEF) ≥ 50% was observed. Patients were divided into super-responders group and non-super-responders group. All-cause mortality or hospitalization for heart failure (HF) was referred to the combined end point. Results. 17 (23.3%) patients were super-responders. HF duration, left atrial dimension (LAD), and left bundle branch block (LBBB) were independent predictors of super-response to CRT. The combination of HF duration and LAD could provide more robust prediction of super-response than standalone HF duration (0.899 versus 0.789, Z = 2.207, P = 0.027) or standalone LAD (0.899 versus 0.775, Z = 2.487, P = 0.013). super-responders had excellent LV reverse remodeling. The cumulative incidences of combined end point were significantly lower in the super-responders group, LAD ≤ 42mm group, and combination of HF duration ≤ 48 months and LAD ≤ 42mm group. LBBB remained associated with a lowered risk of the combined end point (HR: 0.19, 95% CI: 0.07-0.57, P = 0.003), whereas LAD was associated with a raised risk of the combined end point (HR: 1.09, 95% CI: 1.02-1.17, P = 0.014). Conclusions. HF duration, LAD, and LBBB independently predicted super-response. The combination of HF duration and LAD makes more robust prediction of CRT super-response. Super-responders had excellent LV reverse remodeling and decreased the incidences of the combined end point. LBBB and LAD were independently associated with the combined end point.

Minimally Invasive Video-Assisted Epicardial Lead Cardiac Resynchronization Therapy for the Dilated Cardiomyopathy Heart Failure Cases

2010 ◽  
Vol 5 (5) ◽  
pp. 345-348 ◽  
Author(s):  
Hai-Bo Zhang ◽  
Xu Meng ◽  
Jie Han ◽  
Yan Li ◽  
Ya-Ping Zeng ◽  
...  
Keyword(s):  
Heart Failure ◽  
Congestive Heart Failure ◽  
Minimally Invasive ◽  
Cardiac Resynchronization Therapy ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Video Assisted ◽  
Epicardial Lead ◽  
The Mean

Objective Cardiac resynchronization therapy (CRT) with biventricular pacing has demonstrated cardiac function improvement in treating congestive heart failure. Traditional CRT through coronary sinus lead method is difficult to perform. Minimally invasive video-assisted epicardial lead (Epi-lead) CRT for the dilated cardiomyopathy heart failure cases was explored. Methods From April 2007 to June 2009, a total of 12 patients (age, 63 ± 9 years) with depressed systolic left ventricular (LV) function (ejection fraction, <35%), left bundle branch block (mean QRS [Q wave, R wave, S wave], 158 ± 15 milliseconds), and congestive heart failure of New York Heart Association class III/IV were enrolled. The patients received minimally invasive video-assisted epicardial steroid-eluting LV lead implantation for the CRT. The right atrial and right ventricle leads were implanted, guided by x-ray. The mean follow-up time was 13.7 months (range, 7–27 months). Results All patients received LV lead implantation at the most late-activated site. The mean QRS duration decreased significantly from 158 ± 15 to 124 ± 11 milliseconds (P < 0.05). There was no surgical or hospital mortality in the entire series. The mean procedure duration (skin to skin) of the LV lead implantation was 52.4 ± 15.8 minutes. The mean postoperative stay was 7.1 ± 2.7 days. During the follow-up, cardiac function improved significantly in 11 patients. Threshold capture of the Epi-leads remained stable at 1.12 ± 0.3 V/0.5 ms during the follow-up. None died during the follow-up. Conclusions Surgical Epi-lead placement for the resynchronization therapy is a safe and reliable technique and should be considered as an equal alternative.

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