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http://dx.doi.org/10.1016/j.hrcr.2024.03.006DOI Listing

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Background: Interventricular dyssynchrony derived from the classic non-physiological stimulation (n-PS) of the right ventricle (RV) is a known cause of left ventricular dysfunction (LVDys).

Methods: This was a prospective descriptive single-center study. We analyzed patients who develop LVDys with n-PS, and the results after upgrading to conduction system pacing (CSP).

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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.
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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.
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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.

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