Publications by authors named "Daniel B Fyenbo"
Purpose To assess long-term geometric changes of the mitral valve apparatus using cardiac CT in individuals who underwent cardiac resynchronization therapy (CRT). Materials and Methods Participants from a randomized controlled trial with cardiac CT examinations before CRT implantation and at 6 months follow-up (Clinicaltrials.gov identifier NCT01323686) were invited to undergo an additional long-term follow-up cardiac CT examination.
View Article and Find Full Text PDFAims: Several studies have evaluated the use of electrically- or imaging-guided left ventricular (LV) lead placement in cardiac resynchronization therapy (CRT) recipients. We aimed to assess evidence for a guided strategy that targets LV lead position to the site of latest LV activation.
Methods And Results: A systematic review and meta-analysis was performed for randomized controlled trials (RCTs) until March 2023 that evaluated electrically- or imaging-guided LV lead positioning on clinical and echocardiographic outcomes.
Article Synopsis
- This study aimed to evaluate the safety and feasibility of using MRI in patients with temporary external pacemakers, focusing on whether artifacts affect the quality of cardiac MRI images.
- The review analyzed data from 827 patients treated with temporary external pacemakers between 2016 and 2020, finding that only 44 patients (5%) underwent MRI, and there were no device-related issues or artifacts affecting image quality.
- The conclusion is that MRI is both safe and effective for patients with temporary external pacing, providing critical information for their clinical management without compromising diagnostic image quality.
Purpose: To evaluate the association between different right ventricular (RV) lead positions as assessed by cardiac computed tomography (CT) and echocardiographic and clinical outcomes in patients receiving cardiac resynchronization therapy (CRT).
Methods: We reviewed patient records of all 278 patients included in two randomized controlled trials (ImagingCRT and ElectroCRT) for occurrence of heart failure (HF) hospitalization or all-cause death (primary endpoint) during long-term follow-up. Outcomes were compared between RV lead positions using adjusted Cox regression analysis.
Article Synopsis
- The study examines the long-term effects of individualized multimodality imaging-guided left ventricular (LV) lead placement versus routine fluoroscopic methods in cardiac resynchronization therapy (CRT) on heart failure hospitalization and all-cause death among patients.
- Results showed no significant difference in heart failure hospitalization or overall mortality rates between the imaging-guided and control groups, although a notable reduction in risk was observed in patients with inter-lead electrical delay (IED) of 100 ms or more.
- The study concludes that while the imaging-guided strategy did not improve outcomes over routine methods, exploring alternatives like targeting the latest electrical activation may enhance LV lead placement in CRT patients.
Introduction: In cardiac resynchronization therapy (CRT) devices, transvenous left ventricular (LV) leads are more prone to instability, high pacing thresholds, and phrenic nerve stimulation (PNS) that may necessitate lead revision, replacement in a suboptimal position, or deactivation of the lead. To overcome some of these challenges, quadripolar (QP) LV leads have been developed and accounted for over 90% of implanted LV leads 5 years after they were introduced.
Areas Covered: This review provides an overview of the current evidence of implanting QP leads in CRT as compared with traditional bipolar (BP) leads including details about feasibility, safety and lead performance, clinical outcomes and cost-effectiveness.
We present a case of new-onset asthma in a 35-year-old man who had undergone bilateral lung transplantation 11 years before due to idiopathic bronchiectasis and pulmonary hypertension. He presented with recurrent episodes of breathlessness, wheezing and coughing. Spirometry demonstrated severe airway obstruction.
View Article and Find Full Text PDFAims: To test in a double-blinded, randomized trial whether the combination of electrically guided left ventricular (LV) lead placement and post-implant interventricular pacing delay (VVd) optimization results in superior increase in LV ejection fraction (LVEF) in cardiac resynchronization therapy (CRT) recipients.
Methods And Results: Stratified according to presence of ischaemic heart disease, 122 patients were randomized 1:1 to LV lead placement targeted towards the latest electrically activated segment identified by systematic mapping of the coronary sinus tributaries during CRT implantation combined with post-implant VVd optimization (intervention group) or imaging-guided LV lead implantation by cardiac computed tomography venography, 82Rubidium myocardial perfusion imaging and speckle tracking echocardiography targeting the LV lead towards the latest mechanically activated non-scarred myocardial segment (control group). Follow-up was 6 months.
Objectives: Before cardiac resynchronization therapy (CRT) implantation, cardiac computed tomography (CT) can provide assessment of cardiac venous anatomy and visualize left ventricular (LV) myocardial scar. We hypothesized that localization and burden of transmural myocardial scar verified by cardiac CT are associated with echocardiographic and clinical response to CRT.
Methods: We prospectively included 140 CRT recipients undergoing preimplant cardiac CT.
Background: Cardiac resynchronization therapy (CRT) induces segmental left ventricular (LV) remodeling. The LV lead position (LV-LP) affects response to CRT and remodeling.
Objective: We aimed to assess segmental remodeling concordant, adjacent, and remote to LV-LP using cardiac computed tomography (CT).