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This page shows you the latest news and research items in this category.

A Randomized Study of Cardiac Resynchronization Therapy Defibrillator Versus Dual-Chamber Implantable Cardioverter-Defibrillator in Ischemic Cardiomyopathy With Narrow QRS: The NARROW-CRT Study [Original Articles]
Conclusions— In this comparison of CRT defibrillator and dual-chamber implantable cardioverter-defibrillator, CRT improved clinical status in some patients with ischemic cardiomyopathy, mild-to-moderate symptoms, narrow QRS duration, and mechanical dyssynchrony on echocardiography. Clinical Trial Registration— URL: http://clinicaltrials.gov. Unique identifier: NCT01577446. (Source: Circulation: Arrhythmia and Electrophysiology)
Source: Circulation: Arrhythmia and Electrophysiology - June 18, 2013 Category: Cardiology Authors: Muto, C., Solimene, F., Gallo, P., Nastasi, M., La Rosa, C., Calvanese, R., Iengo, R., Canciello, M., Sangiuolo, R., Diemberger, I., Ciardiello, C., Tuccillo, B. Tags: Congestive, Pacemaker Original Articles Source Type: research

Cardiac Resynchronization Therapy Improves Altered Na Channel Gating in Canine Model of Dyssynchronous Heart Failure [Original Articles]
Conclusions— CRT improves DHF-induced alterations of Na+ channel function, especially suppression of INa-L, thus, abbreviating the APD and reducing the frequency of early afterdepolarizations. Changes in the levels of phosphorylated Ca2+/Calmodulin protein kinase II suggest a molecular pathway for regulation of INa by biventricular pacing of the failing heart. (Source: Circulation: Arrhythmia and Electrophysiology)
Source: Circulation: Arrhythmia and Electrophysiology - June 18, 2013 Category: Cardiology Authors: Aiba, T., Barth, A. S., Hesketh, G. G., Hashambhoy, Y. L., Chakir, K., Tunin, R. S., Greenstein, J. L., Winslow, R. L., Kass, D. A., Tomaselli, G. F. Tags: Other heart failure, Pacemaker, Arrythmias-basic studies, Ion channels/membrane transport Original Articles Source Type: research

Evaluating the Results of Transcatheter Versus Surgical Aortic Valve Replacement The Value of a Core Echocardiographic Laboratory ∗
Echocardiography is widely used in both patient care and clinical research because of its entirely noninvasive nature, versatility, availability, portability, and suitability for serial studies. In clinical trials, echocardiography is used to determine study enrollment eligibility, to measure surrogate endpoints, and to provide insights into the natural history and mechanisms of disease and therapeutic efficacy. However, the acquisition and interpretation of echocardiographic data is highly patient- and operator-dependent, which introduces variability and bias and lowers reproducibility. In addition to this performance-b...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 17, 2013 Category: Cardiology Source Type: research

Atrial Fibrillation in Cardiac Resynchronization Therapy with a Defibrillator: A Risk Factor for Mortality, Appropriate and Inappropriate Shocks
ConclusionIn symptomatic CHF patients treated with CRT‐D, history of AF is an independent risk factor for mortality, but also for appropriate and inappropriate shocks. Further efforts in AF management may optimize the care in CRT‐D patients.This article is protected by copyright. All rights reserved. (Source: Journal of Cardiovascular Electrophysiology)
Source: Journal of Cardiovascular Electrophysiology - June 17, 2013 Category: Cardiology Authors: NICK VAN BOVEN, DOMINIC THEUNS, KJELL BOGAARD, JAAP RUITER, GEERT KIMMAN, LILY BERMAN, TJEERD VAN DER PLOEG, ISABELLA KARDYS, VICTOR UMANS Tags: Original Clinical Source Type: research

Cardiac magnetic resonance-derived anatomy, scar, and dyssynchrony fused with fluoroscopy to guide LV lead placement in cardiac resynchronization therapy: a comparison with acute haemodynamic measures and echocardiographic reverse remodelling
Conclusion CMR guidance compared well when validated against the AHR. Lead placement was possible in the CMR target region in most patients with an AHR comparable with the best achieved in any CS branch. The chronic response was significantly better in patients paced in a CMR target segment. These results suggest that CMR guidance may represent a clinically useful tool for CRT. (Source: European Journal of Echocardiography)
Source: European Journal of Echocardiography - June 13, 2013 Category: Cardiology Authors: Shetty, A. K., Duckett, S. G., Ginks, M. R., Ma, Y., Sohal, M., Bostock, J., Kapetanakis, S., Singh, J. P., Rhode, K., Wright, M., O'Neill, M. D., Gill, J. S., Carr-White, G., Razavi, R., Rinaldi, C. A. Tags: ORIGINAL PAPERS Source Type: research

Comparison of three-dimensional echocardiographic software packages for assessment of left ventricular mechanical dyssynchrony and prediction of response to cardiac resynchronization therapy
Conclusion Different 3DE software packages for the assessment of mechanical dyssynchrony should not be used interchangeably until better software standardization is achieved. Dyssynchrony assessment with 3DE for the prediction of response to CRT seems particularly useful in patients with non-ischaemic cardiomyopathy. (Source: European Journal of Echocardiography)
Source: European Journal of Echocardiography - June 13, 2013 Category: Cardiology Authors: Aly, M. F. A., Kleijn, S. A., de Boer, K., Abd El-Hady, Y. A., Sorour, K. A., Kandil, H. I., van Rossum, A. C., Kamp, O. Tags: ORIGINAL PAPERS Source Type: research

Imaging Electrical Dyssynchrony ∗
Cardiac resynchronization therapy (CRT) is a revolutionary technique that is an important part of the standard of care for refractory heart failure in patients with cardiomyopathy and conduction delay. Because of its effect on the natural history of cardiomyopathy in the presence of interventricular conduction delay, CRT is now routinely used in patients whose heart failure symptoms are mild. Despite its importance as a therapy, CRT has been plagued with a nonresponse rate in the range of 30%. Oddly, a similar nonresponse rate was noted with the first description of CRT (1). The nonresponse rate to CRT has varied little in...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 10, 2013 Category: Cardiology Source Type: research

Noninvasive Electrocardiographic Mapping to Improve Patient Selection for Cardiac Resynchronization Therapy Beyond QRS Duration and Left Bundle Branch Block Morphology
This study sought to investigate whether noninvasive electrocardiographic activation mapping is a useful method for predicting response to cardiac resynchronization therapy (CRT).BackgroundOne third of the patients appear not to respond to CRT when they are selected according to QRS duration.MethodsWe performed electrocardiographic activation mapping in 33 consecutive CRT candidates (QRS duration ≥120 ms). In 18 patients, the 12-lead electrocardiographic morphology was left bundle branch block (LBBB), and in 15, it was nonspecific intraventricular conduction disturbance (NICD). Three indexes of electrical dyssynchrony w...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - June 10, 2013 Category: Cardiology Source Type: research

Emerging Role of Three‐Dimensional Speckle Tracking Strain for Accurate Quantification of Left Ventricular Dyssynchrony
In conclusions, a newly developed 3D speckle tracking strain can provide a comprehensive evaluation of “true” LV mechanical dyssynchrony from pyramidal 3D data sets acquired in the same beat, thus yielding more accurate information than previously possible with the 2D speckle tracking system. (Source: Echocardiography)
Source: Echocardiography - June 6, 2013 Category: Cardiology Authors: Hidekazu Tanaka, Kazuhiro Tatsumi, Kensuke Matsumoto, Hiroya Kawai, Ken‐ichi Hirata Tags: Case Report Source Type: research

Endothelial Dysfunction is a Marker of Systemic Response to the Cardiac Resynchronization Therapy in Heart Failure
Conclusions: ED is not an independent predictor of CRT response, but it is able to intercept the systemic effects of CRT and is an affordable marker of response to CRT, especially in patients unable to perform the 6MWT. (Source: Journal of Cardiac Failure)
Source: Journal of Cardiac Failure - June 1, 2013 Category: Cardiology Authors: Luca Santini, Ambrogio Capria, Arianna Di Molfetta, Karim Mahfouz, Germana Panattoni, Valentina Minni, Domenico Sergi, Giovanni B. Forleo, Francesco Romeo Tags: Clinical Investigations Source Type: research

The Systolic Index: A Noninvasive Approach for the Assessment of Cardiac Function: Implications for Patients with DDD and CRT Devices
ConclusionThe noninvasive SI obtained with a simple, observer‐independent hemodynamic assessment procedure has higher accuracy than SBP and AoVTI and better sensitivity than SBP. It detects mechanical resynchronization in CRT and allows programming a suitable AV delay. (Source: Pacing and Clinical Electrophysiology : PACE)
Source: Pacing and Clinical Electrophysiology : PACE - June 1, 2013 Category: Cardiology Authors: RAUL CHIRIFE, G. AURORA RUIZ, ENRIQUE GAYET, CLAUDIO MURATORE, HÉCTOR MAZZETTI, ALEJANDRO PELLEGRINI, M. CRISTINA TENTORI Tags: ORIGINAL ARTICLE Source Type: research

Normalization of Left Ventricular Ejection Fraction after Cardiac Resynchronization Therapy Also Normalizes Survival
ConclusionsNormalization of LVEF by CRT improves survival to levels comparable to the general population. This observation favors the concept that some CRT candidates have a cardiomyopathy likely generated by the conduction abnormality that is reversible through biventricular pacing. (Source: Pacing and Clinical Electrophysiology : PACE)
Source: Pacing and Clinical Electrophysiology : PACE - May 29, 2013 Category: Cardiology Authors: MAHESH MANNE, JOHN RICKARD, NIRAJ VARMA, MINA K. CHUNG, PATRICK TCHOU Tags: ORIGINAL ARTICLE Source Type: research

Interaction between Cardioverter Defibrillator and Enhanced External Counterpulsation Device
ConclusionsEECP seems to be a safe treatment modality in patients with implanted ICD and CRT‐D devices. It should be kept in mind that in those patients with CRT‐D, rate responsive mode is on; inappropriate sinus tachycardia can be seen during EECP therapy. Also in patients with CRT‐D using a unipolar sensing mode, problems of QRS complex sensing by the EECP may occur and, therefore, this effects synchronization and success of EECP therapy. (Source: Pacing and Clinical Electrophysiology : PACE)
Source: Pacing and Clinical Electrophysiology : PACE - May 28, 2013 Category: Cardiology Authors: OMER CELIK, ALPER AYDIN, MUSTAFA S. YILMAZER, NEDIM U. SARIGUL, TAYFUN GUROL, BAHADIR DAGDEVIREN Tags: ORIGINAL ARTICLE Source Type: research

Treatment of left ventricular non-compaction with cardiac resynchronization therapy
(Source: QJM)
Source: QJM - May 28, 2013 Category: Internal Medicine Authors: Guha, K., Treibel, T. A., Roussin, I., Prasad, S. K., Duncan, A. M., Brookes, C., McDonagh, T. A., Sharma, R. Tags: Case reports Source Type: research

Pathophysiology of Cardiorenal Syndrome Type 2 in Stable Chronic Heart Failure: Workgroup Statements from the Eleventh Consensus Conference of the Acute Dialysis Quality Initiative (ADQI).
Abstract In cardiorenal syndrome (CRS) type 2, chronic heart failure (HF) results in the onset or progression of chronic kidney disease (CKD). Examples of CRS type 2 (CRS2) include progressive CKD resulting from chronic HF in congenital or acquired heart disease or from repeated bouts of acute decompensated HF. Animal data and clinical studies indicate that extended periods of chronic HF result in altered renal hemodynamics followed by progressive renal pathology. Experimental and clinical data indicate that CRS2 is characterized by mild to moderate proteinuria, a progressive decline of glomerular filtration rate, ...
Source: Contributions to Nephrology - May 26, 2013 Category: Urology & Nephrology Authors: Cruz DN, Schmidt-Ott KM, Vescovo G, House AA, Kellum JA, Ronco C, McCullough PA Tags: Contrib Nephrol Source Type: research

Identifying patients for advanced heart failure therapy by screening patients with cardiac resynchronization therapy or implantable cardioverter-defibrillator: A pilot study
Heart transplantation (HTx) and left ventricular assist devices (LVADs) improve symptoms and survival in patients with severe heart failure (HF). LVADs are used mainly as a bridge to transplantation (BTT), but with improving outcomes with continuous-flow devices, they are increasingly used as permanent destination therapy (DT). However, patients with advanced HF are believed to be underserved by HTx and LVAD. Cardiac resynchronization therapy (CRT) and implantable cardioverter-defibrillators (ICD) improve prognosis in HF, but only about two thirds respond to CRT, and ICD does not improve symptoms. Care of CRT/ICD patients ...
Source: The Journal of Heart and Lung Transplantation - May 26, 2013 Category: Transplant Surgery Authors: Stanislava Zabarovskaja, Fredrik Gadler, Anders Gabrielsen, Cecilia Linde, Lars H. Lund Tags: Research Correspondence Source Type: research

Devices in Heart Failure
Survival for heart failure patients has improved substantially over the last decades. This is a result of improved pharmacologic treatment, multidisciplinary management strategies and recent advances in device therapy, such as implantable cardiac defibrillators (ICD) and cardiac resynchronization therapy (CRT). Read more Topics: Heart Failure (HF) (Source: ESC News and Press)
Source: ESC News and Press - May 25, 2013 Category: Cardiology Source Type: news

Clinical relevance of slow ventricular tachycardia in heart failure patients with primary prophylactic implantable cardioverter defibrillator indication
Conclusion Incidence of slow VTs in a typical heart failure population with primary prophylactic ICD-implantation ± resynchronization therapy is very low. Slow VTs detected in the ICD monitor zone remained clinically asymptomatic. Thus, single chamber and atriobiventricular ICDs with a VT/ventricular fibrillation zone of ≥187 b.p.m. and one burst before shock delivery might be sufficient and pragmatic for the vast majority of these patients. (Source: Europace)
Source: Europace - May 24, 2013 Category: Cardiology Authors: Lusebrink, U., Duncker, D., Hess, M., Heinrichs, I., Gardiwal, A., Oswald, H., Konig, T., Klein, G. Tags: Sudden death and ICDs Source Type: research

Many response criteria are poor predictors of outcomes after cardiac resynchronization therapy: validation using data from the randomized trial
Conclusion Only some of the commonly used response criteria predict outcome in patients undergoing CRT. The predictive value varies substantially across different criteria, with a higher sensitivity observed for the clinical parameters and a higher specificity observed for echocardiographic parameters. Combining various criteria adds little to their prognostic value. The predictive accuracy of various criteria can be different in various subgroups due to multiple interactions with baseline characteristics. ClinicalTrials. Gov Identifier NCT00814840. (Source: Europace)
Source: Europace - May 24, 2013 Category: Cardiology Authors: Boidol, J., Sredniawa, B., Kowalski, O., Szulik, M., Mazurek, M., Sokal, A., Pruszkowska-Skrzep, P., Kukulski, T., Kalarus, Z., Lenarczyk, R., for the Triple-Site Versus Standard Cardiac Resynchronisation Trial (TRUST CRT) Investigators Tags: Pacing and resynchronization therapy Source Type: research

Cardiac resynchronization therapy improves minute ventilation/carbon dioxide production slope and skeletal muscle capillary density without reversal of skeletal muscle pathology or inflammation
Conclusion Cardiac resynchronization therapy, with improved functional status and reduced LVEDD resulted in increased peak VO2, improvement in VE/VCO2 slope and capillary density in skeletal muscle, with no reduction in systemic pro-inflammatory cytokines, increase in intramuscular levels of mediators of mitochondrial biosynthesis or improvement in skeletal muscle ultrastructure per se. ClinicalTrials.gov Identifier: NCT01019915. (Source: Europace)
Source: Europace - May 24, 2013 Category: Cardiology Authors: Larsen, A. I., Lindal, S., Myreng, K., Ogne, C., Kvaloy, J. T., Munk, P. S., Aukrust, P., Yndestad, A., Dickstein, K., Nilsen, D. W. T. Tags: Pacing and resynchronization therapy Source Type: research

Temporal Trends in Treatment and Outcomes for Advanced Heart Failure With Reduced Ejection Fraction From 1993-2010: Findings From a University Referral Center [Original Articles]
Conclusions— Over the past 2 decades, patients with advanced HF referred to and managed at a tertiary university referral center have benefited from advances in HF medications and devices, as evidenced by improvements in overall survival and sudden death risk. (Source: Circulation: Heart Failure)
Source: Circulation: Heart Failure - May 21, 2013 Category: Cardiology Authors: Loh, J. C., Creaser, J., Rourke, D. A., Livingston, N., Harrison, T. K., Vandenbogaart, E., Moriguchi, J., Hamilton, M. A., Tseng, C.-H., Fonarow, G. C., Horwich, T. B. Tags: Health policy and outcome research, Congestive Original Articles Source Type: research

Echocardiography-Guided Left Ventricular Lead Placement for Cardiac Resynchronization Therapy: Results of the Speckle Tracking Assisted Resynchronization Therapy for Electrode Region Trial [Original Articles]
Conclusions— A strategy of EG LV lead placement for cardiac resynchronization therapy improved patient outcomes by reducing the combined risk of death or HF hospitalizations and has implications for delivery of cardiac resynchronization therapy. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT00156390. (Source: Circulation: Heart Failure)
Source: Circulation: Heart Failure - May 21, 2013 Category: Cardiology Authors: Saba, S., Marek, J., Schwartzman, D., Jain, S., Adelstein, E., White, P., Oyenuga, O. A., Onishi, T., Soman, P., Gorcsan, J. Tags: Congestive, Pacemaker, Echocardiography Original Articles Source Type: research

Right Ventricular Function, Pulmonary Pressure Estimation, and Clinical Outcomes in Cardiac Resynchronization Therapy [Original Articles]
Conclusions— In this population with mild heart failure symptoms, CRT was associated with improvement in RVF, which improved in parallel with improvement in left ventricular function. Patients with the best RVF at 1 year demonstrated the lowest subsequent event rates. Clinical Trial Registration— URL: http://www.clinicaltrials.gov. Unique identifier: NCT01294449. (Source: Circulation: Heart Failure)
Source: Circulation: Heart Failure - May 21, 2013 Category: Cardiology Authors: Campbell, P., Takeuchi, M., Bourgoun, M., Shah, A., Foster, E., Brown, M. W., Goldenberg, I., Huang, D. T., McNitt, S., Hall, W. J., Moss, A., Pfeffer, M. A., Solomon, S. D., for the Multicenter Automatic Defibrillator Implantation Trial With Cardiac Resy Tags: Congestive, Pacemaker Original Articles Source Type: research

Interplay Between Right Ventricular Function and Cardiac Resynchronization Therapy An Analysis of the CARE-HF Trial (Cardiac Resynchronization–Heart Failure)
ObjectivesThe aim of this study was to investigate the impact of cardiac resynchronization therapy (CRT) on right ventricular (RV) function and the influence of RV dysfunction on the echocardiographic and clinical response to CRT among patients enrolled in the CARE-HF (Cardiac Resynchronization-Heart Failure) trial.BackgroundCardiac resynchronization therapy prolongs survival in appropriately selected patients with heart failure but the benefit might be diminished in patients with RV dysfunction.MethodsOf 813 patients enrolled in the CARE-HF study, 688 had tricuspid plane systolic excursion (TAPSE) measured at baseline, an...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - May 20, 2013 Category: Cardiology Source Type: research

Is Electricity Useful When the Pump Is Failing? More Data Urgently Needed ⁎ ⁎
The benefit of prophylactic implantation of an implantable cardioverter-defibrillator (ICD) or cardiac resynchronization therapy (CRT) ICD (CRT-D) in improving mortality in patients with heart failure has been firmly established by multiple randomized controlled trials (RCT) (1,2,3,4). However, it has also been well documented that patients receiving ICDs in the “real world” are older and sicker, with higher prevalences of diabetes, hypertension, and atrial fibrillation than are those enrolled in the landmark RCTs (1,3,5). It is an inherent limitation of RCTs that strict entry criteria limit “real-world” generaliza...
Source: Journal of the American College of Cardiology: Cardiovascular Interventions - May 20, 2013 Category: Cardiology Source Type: research

Abstract 3: Healthcare Resource Utilization and Expenditures Associated with Implantable Cardioverter Defibrillator Shocks [Concurrent Session I Session A: Oral Abstract Presentations on Less is More]
Conclusion: Nearly 1 in 8 shock events were followed by hospitalization. Expenditures were higher when inpatient care followed a shock event as compared to when all care occurred in the outpatient setting. Strategies to reduce the incidence of ICD shocks may result in significant healthcare savings. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Turakhia, M. P., Reynolds, M. R., Gunnarson, C. L., Swain, A. L., Mollenkopf, S. A., Zweibel, S. L. Tags: Concurrent Session I Session A: Oral Abstract Presentations on Less is More Source Type: research

Abstract 83: Association of Preoperative Anemia with Heart Failure Hospitalization and Mortality among Veterans Undergoing Cardioverter-Defibrillator [Poster Session I]
Conclusions: Preoperative anemia is associated with an increased risk of both subsequent heart failure hospitalization and mortality among veterans undergoing ICD implantation even after controlling for comorbidities. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Schneider, P. M., Katz, D. F., Pelligrini, C. N., Heidenreich, P. A., Aleong, R. G., Keung, E. C., Massie, B. M., Varosy, P. D. Tags: Poster Session I Source Type: research

Abstract 165: What Risk Factors are Associated with Heart Failure Readmission? [Poster Session II]
Conclusions: Our single center, retrospective study shows an obesity paradox and a protective effect seen with heart failure medications as well as lipid lowering medications. This information may be used to target at risk patients in order to decrease readmission by establishing close follow-up and maximizing medical therapies. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Safi, L., Patel, A., Cha, C., Skaf, J., Cha, R. Tags: Poster Session II Source Type: research

Abstract 227: Prescribing Warfarin at Discharge for Heart Failure Patients without Atrial Fibrillation Findings from the Get With The Guidelines-Heart Failure Registry [Poster Session II]
Conclusions: Approximately 1 in 10 HF patients without AF or other documented indications are prescribed warfarin at discharge, and prescription rates vary widely across hospitals. Further research is needed to understand why anticoagulation is prescribed to patients with HF in the absence of documented indications. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Eapen, Z., Grau-Sepulveda, M., Fonarow, G., Heidenreich, P., Peterson, E., Hernandez, A. Tags: Poster Session II Source Type: research

Abstract 259: The Role of Gender in Cardiac Resynchronization Therapy Response in Patients with Optimal Anatomical and Electrical Left Ventricular Lead Location. [Poster Session III]
Conclusion: In CRT patients with optimal lead location, females have superior outcomes with respect to reverse remodeling but gender differences donot appear to predict clinical outcomes. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Bose, A., Kandala, J., Singh, J. P. Tags: Poster Session III Source Type: research

Abstract 272: The Role of Diabetes Mellitus in Cardiac Resynchronization Therapy Response in Patients with Optimal Anatomical and Electrical Left Ventricular Lead Location. [Poster Session III]
Conclusion: In CRT patients with optimal lead location and Diabetes, there is a trend towards worse outcomes. This could be the setting of Diabetes related cardiomyopathy and the higher incidence of ischemic heart disease in diabetics. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - May 15, 2013 Category: Cardiology Authors: Bose, A., Kandala, J., Singh, J. P. Tags: Poster Session III Source Type: research

Cardiac resynchronization therapy: state of the art 2013
This article will address the updated CRT guideline and potentially new indications of CRT such as patients with New York Heart Association Class I, normal QRS duration, and non-HF patients with pacing indications. Furthermore, important but unresolved issues will also be discussed which include the impact of QRS morphology and QRS duration on CRT response, new approaches for placement of left ventricular (LV) lead, multisite LV pacing, and the role of HF disease monitoring program. (Source: European Heart Journal)
Source: European Heart Journal - May 14, 2013 Category: Cardiology Authors: Yu, C.-M., Hayes, D. L. Tags: REVIEW Source Type: research

Predictors of Pacemaker Dependence and Pacemaker Dependence as a Predictor of Mortality in Patients with Implantable Cardioverter Defibrillator
ConclusionsIn this single‐center ICD cohort, the development of PD was not uncommon and was associated with decreased survival. (Source: Pacing and Clinical Electrophysiology : PACE)
Source: Pacing and Clinical Electrophysiology : PACE - May 13, 2013 Category: Cardiology Authors: NITESH SOOD, ERIC CRESPO, MEIR FRIEDMAN, DANETTE GUERTIN, STEVEN ZWEIBEL, JEFFREY KLUGER, CHRISTOPHER A. CLYNE Tags: ORIGINAL ARTICLES Source Type: research

Optimizing Cardiac Resynchronization Therapy for Congestive Heart Failure
Abstract: In patients with advanced systolic heart failure and mechanical dyssynchrony, cardiac resynchronization therapy (CRT) is an effective means of improving symptoms and reducing mortality. There are now several recognized approaches to optimize CRT. Imaging modalities can assist with identifying the myocardium with the latest mechanical activation for targeted left ventricular lead implantation. Device programming can be tailored to maximize biventricular pacing, and thereby is its benefit. Cardiac imaging has shown that atrioventricular and interventricular intervals can be adjusted to further reduce dyssynchrony....
Source: Current Problems in Cardiology - May 10, 2013 Category: Cardiology Authors: Srikant Duggirala, Byron K. Lee Source Type: research

The effects of cardiac resynchronization treatment on autonomic functions aside from functional status in heart failure.
CONCLUSION: The most striking finding in our study is that HRV and HRT values related with parasympathetic activation are better in CRT patients when compared to ICD patients with similar functional status. Therefore, upgrading to CRT may have additional benefits on autonomic functions, which needs further investigation. PMID: 23665985 [PubMed - as supplied by publisher] (Source: The Anatolian Journal of Cardiology)
Source: The Anatolian Journal of Cardiology - May 10, 2013 Category: Cardiology Authors: Arslan U, Balcı MM, Kocaoğlu I, Cimen T, Kalaycı S, Temizhan A Tags: Anadolu Kardiyol Derg Source Type: research

Cardiac Resynchronization Therapy in CKD: A Systematic Review.
CONCLUSIONS: CRT improves left ventricular and renal function in the CKD population with heart failure. Given the increasing use of cardiac devices, further studies examining the effects of CRT on mortality in CKD patients, particularly those with advanced kidney disease, are warranted. PMID: 23660183 [PubMed - as supplied by publisher] (Source: Clinical Journal of the American Society of Nephrology : CJASN)
Source: Clinical Journal of the American Society of Nephrology : CJASN - May 9, 2013 Category: Urology & Nephrology Authors: Garg N, Thomas G, Jackson G, Rickard J, Nally JV, Tang WH, Navaneethan SD Tags: Clin J Am Soc Nephrol Source Type: research

St. Jude Medical Announces CE Mark And Launch Of First Quadripolar CRT Pacemaker
Allure Quadra elevates the standard for Cardiac Resynchronization Therapy Pacemakers St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, today announced CE Mark approval and European launch of its Allure Quadra™ Cardiac Resynchronization Therapy Pacemaker (CRT-P). This CRT-P system offers more pacing options to deliver higher success rates, as evidenced by robust clinical data. Allure Quadra CRT-P brings the quadripolar lead technology to the pacemaker market for the first time... (Source: Health News from Medical News Today)
Source: Health News from Medical News Today - May 2, 2013 Category: Consumer Health News Tags: Medical Devices / Diagnostics Source Type: news

Improvement in Hemodynamic Response Using a Quadripolar LV Lead
ConclusionsA quadripolar lead offers multiple additional pacing options to increase CO acutely compared to conventional bipolar leads. (Source: Pacing and Clinical Electrophysiology : PACE)
Source: Pacing and Clinical Electrophysiology : PACE - May 1, 2013 Category: Cardiology Authors: FERNANDO CABRERA BUENO, JAVIER ALZUETA RODRÍGUEZ, JOSÉ OLAGÜE DE ROS, IGNACIO FERNÁNDEZ‐LOZANO, JUAN JOSÉ GARCÍA GUERRERO, JOAQUÍN FERNÁNDEZ DE LA CONCHA, ANTONIO HERNÁNDEZ MADRID, JOSE MARÍA TOLOSANA VIU, JOAQUÍN OSCA ASENSI, ALBERTO BARRERA Tags: ORIGINAL ARTICLE Source Type: research

[Results of the randomized studies on cardiac resynchronization therapy and the reevaluation of the cardiac ventricular activation in left bundle branch block].
Abstract If New York Heart Association Class II-IV heart failure is present, and ejection fraction ≤35%, electrocardiographic QRS width ≥ 120 ms in the presence of left bundle branch block, cardiac resynchronization therapy is indicated. Reevaluation of the data of cardiac resynchronization trials and electrophysiologic findings in left bundle branch block provided evidence that "true" left bundle branch block requires a QRS width of ≥130 ms (in woman) and ≥140 ms (in man). In "true" left bundle branch block, after the 40th ms of the QRS notched/slurred R waves are characteristic in minimum two of I, aVL, V...
Source: Orvosi Hetilap - May 1, 2013 Category: Journals (General) Authors: Préda I Tags: Orv Hetil Source Type: research

Synchronous intra-myocardial ventricular pacing without crossing the tricuspid valve or entering the coronary sinus
Abstract: Ventricular pacing is most commonly performed at the right ventricular (RV) apex. This is not without risk as placement requires crossing the tricuspid valve (TV) and may cause valvular dysfunction and dyssynchronous activation of the ventricles. The fact that the tricuspid valve lies more apically than the mitral valve allows for the possibility of pacing the ventricles from the right atrium (RA) via the “atrio-ventricular septum” without crossing the TV or entering the coronary sinus (CS). In order to mitigate far field activation inherent to current pacing technology, we constructed a novel lead in which t...
Source: Cardiovascular Revascularization Medicine - May 1, 2013 Category: Cardiology Authors: Tomas Konecny, Christopher V. DeSimone, Paul A. Friedman, Charles Bruce, Samuel J. Asirvatham Tags: Innovation Source Type: research

St. Jude Medical Announces CE Mark and Launch of First Quadripolar CRT Pacemaker
Allure Quadra elevates the standard for Cardiac Resynchronization Therapy Pacemakers ST. PAUL, Minn.--(Healthcare Sales & Marketing Network)--St. Jude Medical, Inc. (STJ), a global medical device company, today announced CE Mark approval and European l... Devices, Cardiology, Regulatory, Product LaunchSt. Jude Medical, Allure Quadra, CRT-P, quadripolar, pacemaker (Source: HSMN NewsFeed)
Source: HSMN NewsFeed - April 30, 2013 Category: Pharmaceuticals Source Type: news

St. Jude Medical Announces CE Mark And Launch Of First Quadripolar CRT Pacemaker
Allure Quadra elevates the standard for Cardiac Resynchronization Therapy Pacemakers St. Jude Medical, Inc. (NYSE:STJ), a global medical device company, today announced CE Mark approval and European launch of its Allure Quadra™ Cardiac Resynchronization Therapy Pacemaker (CRT-P). The first-to-market quadripolar CRT-P system allows for increased implant efficiencies that result in fewer surgical revisions, and offers more pacing options to deliver higher success rates, as evidenced by robust clinical data... (Source: Health News from Medical News Today)
Source: Health News from Medical News Today - April 30, 2013 Category: Consumer Health News Tags: Cardiovascular / Cardiology Source Type: news

Cardiac resynchronization therapy improves ejection fraction and cardiac remodelling regardless of patients' age
Conclusion Cardiac resynchronization therapy is as effective in improving LVEF in elderly as in non-elderly patients. Age alone should not be a determinant to restrict resynchronization therapy in HF patients. (Source: Europace)
Source: Europace - April 26, 2013 Category: Cardiology Authors: Brambatti, M., Guerra, F., Matassini, M. V., Cipolletta, L., Barbarossa, A., Urbinati, A., Marchesini, M., Capucci, A. Tags: Pacing and resynchronization therapy Source Type: research

An 8-year single-centre experience of cardiac resynchronisation therapy: procedural success, early and late complications, and left ventricular lead performance
Conclusion Transvenous implantation of the LV lead is safe and achievable for CRT with high procedural success rates. For the first time we describe the late complications from CRT in different heart failure populations. This group of patients must be kept under surveillance, not only for heart failure events but also for device-related issues. The reasons for higher complication rates in DCM patients require further evaluation. (Source: Europace)
Source: Europace - April 26, 2013 Category: Cardiology Authors: Ahsan, S. Y., Saberwal, B., Lambiase, P. D., Chaubey, S., Segal, O. R., Gopalamurugan, A. B., McCready, J., Rogers, D. P., Lowe, M. D., Chow, A. W. C. Tags: Pacing and resynchronization therapy Source Type: research

Individually tailored left ventricular lead placement: lessons from multimodality integration between three-dimensional echocardiography and coronary sinus angiogram
Conclusion Individualized lead placement at the latest contracting LV site can be performed safely and successfully in the majority of patients. Initial clinical outcome data are encouraging. Identification of target sites requires multimodality integration between LV wall motion data and CS anatomy. Future developments need to improve those technologies and require randomized data on clinical outcome parameters. (Source: Europace)
Source: Europace - April 26, 2013 Category: Cardiology Authors: Doring, M., Braunschweig, F., Eitel, C., Gaspar, T., Wetzel, U., Nitsche, B., Hindricks, G., Piorkowski, C. Tags: Pacing and resynchronization therapy Source Type: research

Empiric versus imaging guided left ventricular lead placement in cardiac resynchronization therapy (ImagingCRT): study protocol for a randomized controlled trial
This study aims to clarify whether multimodality imaging guided LV lead placement improves clinical outcome after CRT. Methods: The ImagingCRT study is a prospective, randomized, patient- and assessor-blinded, two-armed trial. The study is designed to investigate the effect of imaging guided left ventricular lead positioning on a clinical composite primary endpoint comprising all-cause mortality, hospitalization for heart failure, or unchanged or worsened functional capacity (no improvement in New York Heart Association class and (Source: Trials)
Source: Trials - April 26, 2013 Category: Journals (General) Authors: Anders SommerMads KronborgSteen PoulsenMorten BöttcherBjarne NørgaardKirsten BouchelouchePeter MortensenChristian GerdesJens Nielsen Source Type: research

Conflicting Results From Two Trials Of Cardiac Resynchronization Therapy
Two new trials have ended up reporting conflicting results regarding the expansion of the indication for cardiac resynchronization therapy (CRT) for patients without a wide QRS interval. The positive results of the smaller trial seem likely to be undermined by the early stopping of the much larger trial. (Source: Forbes.com Healthcare News)
Source: Forbes.com Healthcare News - April 25, 2013 Category: Pharmaceuticals Authors: Larry Husten Source Type: news

Left ventricular mechanical dyssynchrony by cardiac magnetic resonance is greater in patients with strict vs nonstrict electrocardiogram criteria for left bundle-branch block
Conclusions: Strict LBBB criteria identify patients with greater mechanical dyssynchrony compared with patients only meeting the nonstrict LBBB criteria, whereas there was no significant difference between patients with nonstrict LBBB and non-LBBB. The greater observed LV dyssynchrony may explain why patients with strict LBBB have a better response to cardiac resynchronization therapy. (Source: American Heart Journal)
Source: American Heart Journal - April 25, 2013 Category: Cardiology Authors: Linus G. Andersson, Katherine C. Wu, Björn Wieslander, Zak Loring, Terry F. Frank, Charles Maynard, Gary Gerstenblith, Gordon F. Tomaselli, Robert G. Weiss, Galen S. Wagner, Martin Ugander, David G. Strauss Tags: Electrophysiology Source Type: research

Evaluating the Results of Transcatheter Versus Surgical Aortic Valve Replacement: The Value of a Core Echocardiographic Laboratory∗
Echocardiography is widely used in both patient care and clinical research because of its entirely noninvasive nature, versatility, availability, portability, and suitability for serial studies. In clinical trials, echocardiography is used to determine study enrollment eligibility, to measure surrogate endpoints, and to provide insights into the natural history and mechanisms of disease and therapeutic efficacy. However, the acquisition and interpretation of echocardiographic data is highly patient- and operator-dependent, which introduces variability and bias and lowers reproducibility. In addition to this performance-b...
Source: Journal of the American College of Cardiology - April 25, 2013 Category: Cardiology Authors: Brian D. Hoit Tags: Catheter Versus Surgical Intervention: Editorial Comment Source Type: research

Effect of atrioventricular optimization on circulating N-terminal pro brain natriuretic peptide following cardiac resynchronization therapy
Conclusions In one-third of patients, major filling pattern changes are achieved with AV optimization, associated with subsequent rapid falls in NT-proBNP. The greater the AV delay change, the larger the NT-proBNP fall, and non-responders and those with restrictive or pseudonormal filling despite CRT are most likely to benefit. (Source: European Journal of Heart Failure)
Source: European Journal of Heart Failure - April 22, 2013 Category: Cardiology Authors: Shanmugam, N., Campos, A. G., Prada-Delgado, O., Bizrah, M., Valencia, O., Jones, S., Collinson, P., Anderson, L. Tags: CRT Source Type: research