Clinical Relevance Of Systematic CRT Device Optimization.

Cardiac Resynchronization Therapy (CRT) is known as a highly effective therapy in advanced heart failure patients with cardiac dyssynchrony. However, still one third of patients do not respond (or sub-optimally respond) to CRT. Among the many contributors for the high rate of non-responders, the lack of procedures dedicated to CRT device settings optimization (parameters to regulate AV synchrony and VV synchrony) is known as one of the most frequent.

Left ventricular ejection fraction overcrossing 35% after one year of cardiac resynchronization therapy predicts long term survival and freedom from sudden cardiac death: single center observational experience.

Background: Reverse remodeling and increased LVEF after CRT correlate with survival and heart failure hospitalizations, but their relationship with the risk of SCD is unclear. We aimed to evaluate whether exceeding a threshold value of 35% for left ventricular ejection fraction (LVEF) 1 year after cardiac resynchronization therapy (CRT) predicts survival and freedom from sudden cardiac death (SCD).

Methods: 330 patients who survived ≥ 6 months after CRT (males 80%, age 62 ± 11 years) were grouped according to 1-year LVEF ≤ 35% (Group 1, n=187, 57%) or >35% (Group 2, n=143, 43%).

A caval homograft for Budd-Chiari syndrome due to inferior vena cava obstruction.

Transjugular intrahepatic portosystemic shunt (TIPS) is the standard treatment of Budd-Chiari syndrome (BCS) non responsive to medical therapy. However, patients with inferior vena cava (IVC) obstruction proximal to the atrium do not benefit from TIPS and a surgical approach is mandatory. We report the case of BCS due to intrapericardial IVC obstruction.

[Echocardiographic evaluation of anti-tumor necrosis factor-alpha therapy with infliximab in patients without cardiac pathologies].

In the course of heart failure, plasmatic levels of Tumor Necrosis Factor-alpha (TNF-alpha) are high and are related to prognosis and mortality. Infliximab, a recombinant chimeric antibody anti-TNF-alpha, was used in heart failure with disappointing results, similar to those obtained with other biological drugs.The aim of this study was the echocardiographic evaluation of infliximab infusion in nine patients without cardiac pathologies.

[Risk stratification for sudden cardiac death: should we juist consider ejection fraction?].

Sudden cardiac arrest is a leading cause of death in industrialized countries. There is solid clinical evidence for implantable cardioverter-defibrillators as the only effective means of preventing sudden cardiac arrest and reducing mortality in high-risk patients. The therapeutic strategy has definitively been validated, but we have not yet identified with the same effectiveness the patients who most likely will benefit from such therapy.