Unlabelled: Cardiac resynchronization therapy (CRT) is currently an established device therapy for heart failure (HF) patients. Existing knowledge of implantation techniques, advances in device-based technologies and clinical trial experience have all significantly impacted this evolving therapy in recent years. This review article will address the updated CRT guidelines, and potentially new indications for CRT such as patients with mild HF symptoms and prolonged QRS duration; it also highlights new approaches for placement of the left ventricular (LV) lead, multi-site LV pacing, and the role of automatic device optimization in CRT.
Key Words: Cardiac resynchronization therapy; Guideline; Heart failure; Optimization.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4805028 | PMC |
J Cardiovasc Electrophysiol
January 2025
Division of Cardiology, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Background: Left bundle branch area pacing (LBBAP) is a new technique for patients with atrioventricular block (AVB) and preserved left ventricular ejection fraction (LVEF), potentially offering better cardiac function than right ventricular pacing (RVP).
Methods: We searched databases and registries for studies that compared LBBAP with RVP in patients with AVB and preserved LVEF. We extracted data on various outcomes and pooled the effect estimates using random-effects models.
Am J Nurs
December 2024
Nicole Kupchik is an independent clinical nurse specialist at Nicole Kupchik Consulting in Seattle. Sarah Vance is a critical care facility educator at Trident Medical Center in Charleston, SC. Kupchik also coordinates Strip The authors have disclosed no potential conflicts of interest, financial or otherwise.
Editor's note: This is the next installment in a series on electrocardiogram (ECG) interpretation. Nurses in all settings should know the basics, as medications and physiological changes can cause cardiac arrhythmias. Each article will start with a brief case scenario and an ECG strip and then take you step by step through analyzing the heart rhythm.
View Article and Find Full Text PDFJ Clin Med
December 2024
University Hospital of Grenoble Alpes, INSERM U1300, 38043 Grenoble, France.
Cardiac implantable electronic devices and their integrated thoracic impedance sensors have been used to detect sleep apnea for over a decade now. Despite their usage in daily clinical practice, there are only limited data on their diagnostic accuracy. AIRLESS and UPGRADE were prospective investigator-driven trials meant to validate the AP scan (Boston Scientific, Marlborough, MA, USA) in heart failure cohorts.
View Article and Find Full Text PDFLife (Basel)
November 2024
Department of Cardiology, Bagdasar-Arseni Emergency Hospital, Carol Davila University of Medicine and Pharmacy, 022328 Bucharest, Romania.
Background: Cardiac resynchronization therapy (CRT) is an essential treatment for patients with symptomatic heart failure and ventricular conduction abnormalities. Low-ejection-fraction (EF) cardiomyopathy often involves a wide QRS complex displaying a left bundle branch block (LBBB) morphology and markedly delayed activation of the LV lateral wall. Following CRT, patients with heart failure and LBBB have better outcomes and quality-of-life improvements.
View Article and Find Full Text PDFBiomedicines
November 2024
Doctoral School, University of Medicine and Pharmacy of Craiova, 200349 Craiova, Romania.
Background: When conventional trans-venous CS lead placement fails, trans-septal endocardial left ventricle lead placement is an alternative technique used to capture the left ventricle endocardially; however, its use is limited due to a lack of evidence, practice uptake, and clinical trials.
Methods: In this single-center cohort study, we evaluated the efficiency of the procedure, post-procedural complication rate, rate of thromboembolic events, overall survival rate, and changes in the echocardiographic parameters, brain natriuretic peptide (BNP) level, and New York Heart Association (NYHA) class, both before and after TSLV lead implantation.
Results: The TSLV lead implant is safe and improves EF, LVEDV, LVESV, and LVIDd.
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