By William T. Abraham MD, Ragavendra R. Baliga MD MBA FRCP FACC
Written through famous specialists with day by day adventure in cardiac resynchronization remedy (CRT), this finished, functional reference offers physicians an intensive wisdom of the symptoms, thoughts for implantation, problems, programming, and follow-up of CRT units in sufferers with center failure and intra- and interventricular conduction delays. every one bankruptcy has how-to and troubleshooting sections to assist readers keep away from or navigate the pitfalls encountered in daily medical perform. every one bankruptcy additionally has a precis field shooting the main medical pearls. This ebook might be a helpful reduction in getting ready for the guts Rhythm Exam/International Board of middle Rhythm Examiners (IBHRE) exam.
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Additional resources for Cardiac Resynchronization Therapy in Heart Failure
Example text
Am Heart J. 2002;143:34–44. 37. Ukkonen H, Beanlands RS, Burwash IG, et al. Effect of cardiac resynchronization on myocardial efficiency and regional oxidative metabolism. Circulation. 2003;107:28–31. 38. Nelson GS, Berger RD, Fetics BJ, et al. Left ventricular or biventricular pacing improves cardiac function at diminished energy cost in patients with dilated cardiomyopathy and left bundle-branch block. Circulation. 2000;102:3053–3059. 39. O’Connor CM, Gattis WA, Uretsky BF, et al. Continuous intravenous dobutamine is associated with an increased risk of death in patients with 40.
20 Cardiac Resynchronization Therapy in Heart Failure TA B L E 2 . 1 Authors Rates and Predictors of Acute Improvement in Left Ventricular Systolic Performance with CRT No. of patients* Measured response Response rate (%) Nelson45 22 Sogaard46 25 Ն25% ↑ dP/dt max Ն 10 % ↑ PP ↑ LVEF Kerwin28 13 ↑ LVEF Bax47 Gorcsan III48 Dohi49 Breithardt50 25 29 38 34 Ն 5% ↑ LVEF Ն 15% ↑ SV Ն 15% ↑ SV ↑ dP/dt max 68 52 55 - Suffoletto51 Heist57 48 39 Ն 15% ↑ SV Ն 25% ↑ dP/dt max 67 46 91 - Independent predictors of response Sensitivity/ Specificity (%) QRS Ն 155 and dP/dt max Յ700 mm Hg/s LV dyssynchrony, DLC 100/100 90/100 Response related to improved dyssynchrony Response related to improved dyssynchrony 76/89 87/100 95/88 Response related to improved dyssynchrony 91/75 Interventricular dyssynchrony LV dyssynchrony, Ͼ60 ms cutoff† LV dyssynchrony, Ͼ65 ms cutoff† LV dyssynchrony, Ն130 ms cutoff‡ LV dyssynchrony, Ͼ25% phase delay LV dyssynchrony, Ն130ms cutoff‡ “Response Score” (0–4)¶ 4 points 100/100 DLC, delayed longitudinal contraction; LV, left ventricular; LVEF, left ventricular ejection fraction; PP, pulse pressure; SV, stroke volume; ↑, increase *Only alive patients who had complete follow-up.
Cardiac resynchronization in patients with congestive heart failure and chronic atrial fibrillation: effect of upgrading to biventricular pacing after chronic right ventricular pacing. J Am Colll Cardiol. 200239:1258–1263. 128. Eldadah ZA, Rosen B, Hay I, et al. The benefit of upgrading chronically right ventricle-paced heart failure patients to resynchronization therapy demonstrated by strain rate imaging. Heart Rhythm. 2006;3:435–442. 129. Wittte KKA, Pipes RR, Nanthakumar K, et al. Biventricular pacemaker upgrade in previously paced heart failure patients—Improvements in ventricular dyssynchrony.