scholarly journals P440One-year outcomes of cardiac resynchronization therapy in non-ambulatory NYHA class IV heart failure patients

EP Europace ◽  
2017 ◽  
Vol 19 (suppl_3) ◽  
pp. iii96-iii96
Author(s):  
G. Loughlin ◽  
E. Gonzalez-Torrecilla ◽  
R. Peinado ◽  
C. Alvarez ◽  
P. Avila ◽  
...  
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Nyha Class ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
Class Iv

EFFICACY OF CARDIAC RESYNCHRONIZATION THERAPY IN HEART FAILURE AT HUE UNIVERSITY HOSPITAL

2012 ◽  
pp. 37-43
Author(s):  
Anh Tien Hoang ◽  
Anh Tuan Ho ◽  
Van Minh Huynh ◽  
Van Dien Nguyen
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Nyha Class ◽  
Pacemaker Implantation ◽  
University Hospital ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Heart Failure Patients ◽  
Ventricular Dyssynchrony

Background: Cardiac resynchronization therapy is one of new methods used to treating patients with heart failure who have ventricular dyssynchrony. Objectives: 1. To study clinical, laboratory characteristis of heart failure patients with ventricular dyssynchrony. 2. To study the efficacy of cardiac resynchronization therapy in treating such group of patients. Materials and method: From February 2009 to February 2011, we implanted biventricular pacemakers at Hue University Hospital for 15 patients who had NYHA class III and IV heart failure and had been treated with optimal medical therapy, LVEF ≤35%, QRS duration ≥ 120ms. Result: 14/15 cases succeeded, cardiac function improved after 1 year follow – up of biventricular pacemaker implantation, with significantly increased EF, decreased LVIDd, PAPs. At the cut off of EF <30%, the rate of patients with EF <30% declined chronologically (1 year of follow – up). Functional symptoms improved overtly according to NYHA class. The choice of A-V delay and V-V delay is very important. Optimal A-V delay and V-V delay after programming were (152±8.33)ms and (26.33±6.31)ms, retrospectively. Conclusion: Cardiac resynchronization therapy is effective in improving heart failure patients with ventricular dyssynchronization.

scholarly journals The prognostic significance of cardiac sympathetic activity and dyssynchrony in cardiac resynchronization therapy in ischemic and non-ischemic heart failure patients

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Mishkina ◽  
K Zavadovsky ◽  
V Saushkin ◽  
D Lebedev ◽  
Y Lishmanov
Keyword(s):  
Heart Failure ◽  
Cardiac Resynchronization Therapy ◽  
Sympathetic Activity ◽  
Gated Spect ◽  
Prognostic Significance ◽  
Cardiac Resynchronization ◽  
Resynchronization Therapy ◽  
Cardiac Sympathetic Activity ◽  
Heart Failure Patients ◽  
Crt Response

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Russian Foundation for Basic Research Introduction Impaired cardiac sympathetic activity and contractility are associated with poor prognosis in patients with heart failure after cardiac resynchronization therapy (CRT). There are few prognostic data of the cardiac sympathetic activity and dyssynchrony in patients with chronic heart failure of various etiologies. Purpose To examine the prognostic significance of scintigraphic cardiac sympathetic activity and contractility in predicting the response to CRT and to assess the differences between patients with ischemic (IHF) and non-ischemic (NIHF) heart failure. Methods This study included 38 heart failure patients (24 male; mean age of 56 ± 11 years; 16 patients with ischemic etiology), who were submitted to CRT. Before CRT all patients underwent 123I-metaiodobenzylguanidine (123I-MIBG) imaging for cardiac sympathetic activity evaluating: early and delay heart to mediastinum ratio (eH/M and dH/M), summed MIBG Score (eSMS and dSMS). Moreover all patients underwent gated SPECT with the assessments of left ventricle dyssynchrony indexes: standard deviation (SD) and histogram bandwidth (HBW). In addition, all patients underwent gated blood-pool SPECT (GBPS) to assessed ejection fraction (EF) and stroke volume (SV) of both ventricles. Results One year after CRT response defined as LV ESV decreased by≥15% and/or LV EF increase by≥5%. Baseline cardiac sympathetic activity parameters showed significant differences between responders and non-responders only in NIHF patients: eH/M: 2.27 (2.02–2.41) vs. 1.64 (1.32–2.16); dH/M: 2.18 (2.11–2.19) vs. 1.45 (1.23 – 1.61); eSMS: 7 (5-7) vs. 15.5 (10–28.5); dSMS: 10 (10–13) vs. 16.5 (15.5–29). Significant differences in baseline LV dyssynchrony indexes between responders and non-responders were in patients of both group: in NIHF patients - SD: 54.3 (43–58) degree vs. 65 (62–66) degree; HBW: 179.5 (140–198) degree vs. 211 (208-213) degree, p &lt; 0.054 in IHF patients - HBW: 162 (115.2–180) degree vs.  115.2 (79.2–136.8) degree. Contractility of RV was significantly differed between responders and non-responders in IHF patients: RV EF: 54.5 (41-56) % vs. 44.5 (37–49.5) %; RV SV: 80 (69-101) ml vs. 55.5 (50–72.5) ml. According to univariate logistic regression analyses in IHF patients LV dyssynchrony indexes – SD (OR = 1.55; 95% CI 1.09-2.2; p &lt; 0.5) and HBW (OR = 1.13; 95% CI 1.02-1.24; p &lt; 0.5), as well as RV indexes – RV EF (OR = 1.11; 95% CI 1.001-1.23; p &lt; 0.5), RV SV (OR = 1.07; 95% CI 1.003-1.138; p &lt; 0.5) were predictors of CRT response. In the group of NIHF patients, dH/M (OR = 1.47; 95% CI 1.08-2; p &lt; 0.5), SD (OR = 0.83; 95% CI 0.73-0.95; p &lt; 0.5), HBW (OR = 0.96; 95% CI 0.93-0.99; p &lt; 0.5) showed the predictive value in terms of CRT response. Conclusion  Scintigraphic methods can be used to select patients for CRT. Cardiac 123I-MIBG scintigraphy and gated SPECT may be used for predicting CRT response in NIHF patients. Whereas in IHF patients ECG-gated SPECT and GBPS may be valuable for predicting the response to CRT.

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