scholarly journals Cardiac Resynchronization Therapy in Advanced Heart Failure: Predictors of Response and Optimization of Therapy

10.5772/67037 ◽  
2017 ◽  
Author(s):  
Miguel Ángel García García ◽  
Alfonso Martínez Cornejo ◽  
María de los Ángeles Rosero Arenas
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Advanced Heart Failure ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Predictors Of Response

scholarly journals A case report of advanced heart failure refractory to pharmacological therapy who was successfully recovered by combinatory usage of cardiac resynchronizing therapy, Impella and MitraClip

2020 ◽  
Author(s):  
Mitsuo Sobajima ◽  
Nobuyuki Fukuda ◽  
Hiroshi Ueno ◽  
Koichiro Kinugawa
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Therapeutic Option ◽  
Bed Rest ◽  
Pharmacological Therapy ◽  
Advanced Heart Failure ◽  
Cardiac Resynchronization ◽  
Functional Mitral Regurgitation ◽  
Resynchronization Therapy ◽  
Qrs Duration

Abstract Background  The safety and efficacy of MitraClip for advanced heart failure (HF) patients who are inotrope-dependent or mechanically supported are unknown. Case summary  The patient was a 71-year-old man diagnosed as dilated cardiomyopathy in 2003. He was admitted due to worsening HF in January 2019 and became dependent upon intravenous infusion of inotropes. During the 8-month hospitalization, his haemodynamics were relatively static with bed rest and continuous inotropes, but he was definitely dependent on them. Our multidisciplinary team decided to perform both cardiac resynchronization therapy (CRT) and MitraClip under Impella support. First, Impella was inserted from left subclavian artery. After a week, CRT was implanted from right subclavian vein, and the QRS duration of electrocardiogram became remarkably narrow. MitraClip was performed 2 weeks after Impella, and functional mitral regurgitation improved from severe to mild, and Impella was removed on the same day. Inotropes could be ceased, and he was discharged 2 months after MitraClip. Discussion  During inotrope-dependent status, there was a risk that HF would worsen with haemodynamic collapse when performing CRT implantation, and we firstly supported his haemodynamics by Impella. Cardiac resynchronization therapy implantation before MitraClip seemed to be crucial. In fact, the mitral valve morphology before Impella insertion had very poor coaptation of the anterior and posterior leaflets that was not optimal for MitraClip procedure. But the Impella support and correction of dyssynchrony by CRT markedly improved the coaptation of those leaflets. The combination therapy of CRT and MitraClip unloading with Impella maybe a new therapeutic option for advanced HF.

Influence of Diabetes on Cardiac Resynchronization Therapy With or Without Defibrillator in Patients With Advanced Heart Failure

2007 ◽  
Vol 13 (9) ◽  
pp. 769-773 ◽  
Author(s):  
Jalal k. Ghali ◽  
John Boehmer ◽  
Arthur M. Feldman ◽  
Leslie A. Saxon ◽  
Teresa Demarco ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Advanced Heart Failure ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy
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