AI Article Synopsis
Article Abstract
Background: Lower BiVentricular (BiV) pacing percentages have been associated with significantly worse survival in patients with chronic heart failure (HF). However, the pathophysiology behind this observation has not been further delineated. This analysis evaluated whether small incremental decreases in BiV pacing percentages were associated with worse measures, related to HF physiology using individual sensor trends and the HeartLogic composite index.
Methods: Sensor data was obtained from 900 ambulatory HF patients with implanted CRT devices. The percent of cardiac cycles with BiV pacing was assessed for periods (median = 7.3 days) between data downloads (median = 55 periods/patient).
Results: The third heart sound (S3), respiration rate, RSBI, and night-time heart rate were significantly elevated with sub-optimal pacing (<98%), while the first heart sound (S1), thoracic impedance, and activity were significantly lower. All sensor changes were in the direction associated with worsening HF. While IN the HeartLogic alert state (threshold above an Index of 16) the odds of optimal BiV pacing (≥98%) were less than when OUT of the HeartLogic alert state for a given subject (OR: 0.655; 95% CI: 0.626-0.686; p < 0.0001). The percent BiV pacing was reduced and the HeartLogic Index was increased in the periods surrounding HFhospitalizations.
Conclusion: Lower BiV pacing percent is associated with multiple sensor changes indicative of worsening HF, and patients in HeartLogic alert are more likely to have suboptimal BiV pacing. Collectively, these data provide strong evidence that even small decreases in BiV percent pacing can lead to worsening HF.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.ijcard.2021.03.073 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
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.
Aims: Cardiac resynchronization therapy (CRT) is guideline recommended for the treatment of symptomatic heart failure (HF) with reduced left ventricular ejection fraction and prolonged QRS. However, patients with common comorbidities, such as persistent/permanent atrial fibrillation (AF), are often under-represented in clinical trials.
Methods: The Strategic Management to Optimize Response to Cardiac Resynchronization Therapy (SMART) registry (NCT03075215) was a global, multicentre, registry that enrolled de novo CRT implants, or upgrade from pacemaker or implantable cardioverter defibrillator to CRT-defibrillator (CRT-D), using a quadripolar left ventricular lead in real-world clinical practice.
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 PDFOutcomes of permanent pacemakers and implantable cardioverter-defibrillators in an adult congenital heart disease population.
Int J Cardiol Congenit Heart Dis
March 2024
Sydney Medical School, The University of Sydney, Camperdown, Australia.
Background: Brady- and tachyarrhythmias commonly complicate adult congenital heart disease (ACHD). Permanent pacemakers (PPMs) or implantable cardioverter-defibrillators (ICDs) are often utilised to prevent morbidity or mortality related to arrhythmia, but can also be associated with significant morbidity themselves.
Methods: We analysed outcomes from patients in our comprehensive ACHD database who were seen at least twice since 2000 and once since 2018.
Revamping Pace Distribution: A Case Study on Elevating the Men's 400 m Track and Field Japanese National Record After 32 Years.
J Strength Cond Res
December 2024
Faculty of Sports and Life Science, National Institute of Fitness and Sports in Kanoya, Kanoya, Kagoshima, Japan.
Chiba, Y, Sato, K, Yoshimoto, T, Ohnuma, H, Yamanaka, R, Takahashi, K, Kobayashi, K, Matsubayashi, T, and Takai, Y. Revamping pace distribution: A case study on elevating the men's 400 m track and field Japanese national record after 32 years. J Strength Cond Res XX(X): 000-000, 2024-Many studies have investigated the 400-m sprint, and the optimal pacing strategy is subject to debate.
View Article and Find Full Text PDFEffect of Rate-Adaptive Atrial Support Compared to VDD Pacing in Cardiac Resynchronization Therapy Recipients: A Randomized Cross-Over Study.
Am Heart J
December 2024
Department of Cardiology, San Maurizio Regional Hospital, Bolzano, Italy.
Background: Cardiac resynchronization therapy (CRT) is a cornerstone treatment for heart failure, yet the optimal pacing mode remains uncertain. This study investigates the impact of DDDR (rate-adaptive atrial support) versus VDD pacing modes on functional capacity and echocardiographic outcomes in patients with CRT-defibrillators.
Methods: In a multicenter, double-blind, crossover trial, 26 sinus rhythm patients undergoing CRT-defibrillator implantation were randomized to DDDR at 60 beats-per-minute or VDD at 30 beats-per-minute.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!