Cardiac resynchronization therapy significantly reduces mortality and morbidity in patients with heart failure and ventricular dyssynchrony. This is a dynamic field with some exciting recent advances, and these future directions are discussed in this review.
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Addressing Functional Mitral Regurgitation in Dilated Cardiomyopathy: A Focus on Myocardial Segment Resynchronization Through Cardiac Resynchronization Therapy.
Cureus
November 2024
Department of Cardiology, Liv Hospital Ulus, Istanbul, TUR.
Article Synopsis
- Cardiac resynchronization therapy (CRT) improves functional mitral regurgitation (FMR) by coordinating heart muscle segments, especially between papillary muscles, beyond just boosting left ventricular (LV) performance.
- Eighteen patients with dilated cardiomyopathy underwent tests to measure heart function, and biventricular pacing showed a significant reduction in mitral regurgitation despite some patients showing no change in LV pressure.
- The study concludes that CRT effectively lowers FMR independently of LV systolic function improvements, highlighting the importance of understanding its mechanisms for better treatment outcomes.
Real-world outcomes in cardiac resynchronization therapy patients: Primary results of the SMART registry.
ESC Heart Fail
December 2024
Boston Scientific Corporation, St. Paul, Minnesota, USA.
Article Synopsis
- Cardiac resynchronization therapy (CRT) is effective for treating heart failure but is under-researched in patients with common comorbidities like atrial fibrillation (AF).
- The SMART registry enrolled 2035 patients to assess CRT response based on clinical outcomes over 12 months, focusing on factors like all-cause mortality, hospitalizations, and quality of life.
- Results showed 58.9% of patients improved, but factors like age, AF, and diabetes were linked to lower CRT responsiveness, with patients having AF experiencing higher rates of hospitalizations and mortality compared to those in normal rhythm.
Deep Septal Pacing for Pacemaker-Induced Cardiomyopathy.
Pacing Clin Electrophysiol
December 2024
Servei de Cardiologia, Hospital Universitari de Bellvitge, L'Hospitalet de Llobregat, Barcelona, España.
Introduction: Right ventricular (RV) pacing can impair left ventricular function and cause heart failure, known as pacing-induced cardiomyopathy (PICM). Upgrade to cardiac resynchronization (CRT) is its usual treatment; recently left bundle branch area pacing (LBBAP) has emerged as a potential alternative. Deep septal pacing (DSP), a simplified alternative to LBBAP, is still able to achieve narrower paced QRS than during conventional RV pacing.
View Article and Find Full Text PDFImpact of Procedural Aspects on Early Complications After Permanent Cardiac Implantable Device Implantations.
Pacing Clin Electrophysiol
December 2024
Department of Cardiology, Cardinal Wyszynski Hospital in Lublin, Lublin, Poland.
Background: Cardiac implantable devices (CIED) such as pacemakers, implantable cardioverter-defibrillators, or cardiac resynchronization devices are implanted in selected patients with bradyarrhythmia and advanced heart failure. The invasive character of these procedures poses a risk of early complications such as pneumothorax, bleeding, infections, or dislocations.
Aims: There are no available data that analyzed the impact of the organization of procedures on the early complications risk after permanent pacing procedures.
Health-related quality of life in a large cohort of patients with cardiac implantable electronic devices A registry-based study.
PLoS One
December 2024
Division of Cardiology, Department of Medicine, Karolinska Institutet, Stockholm, Sweden.
Aim: The association of cardiac implantable electronic devices (CIED), namely pacemaker (PM), implantable cardioverter-defibrillator (ICD) and cardiac resynchronization therapy with (CRT-D) or without defibrillator (CRT-P) with health-related quality of life (HRQoL) is lacking.
Methods And Results: Data from the Swedish Pacemaker and ICD Registry collected from January 2019 to February 2022 was used to analyze the responses to the European Quality of Life-5 Dimension questionnaire (EQ-5D) before and after one year of the CIED implant. Descriptive analysis was performed using Pearson's chi-square test, the analysis of variance ANOVA, the Kruskal-Wallis test and Wilcoxon signed-rank test when appropriate.
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