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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.
Ways to resynchronize left ventricle in presence of persistent left superior vena cava.
HeartRhythm Case Rep
October 2024
Department of Cardiology, Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.
Transseptal Sheath Perfused with High Concentration Heparinized Saline for Reducing Sheath-associated Thrombus.
Pacing Clin Electrophysiol
December 2024
Department of Cardiology, Shanghai General Hospital, Shanghai Jiao Tong University, School of Medicine, Shanghai, China.
Article Synopsis
- The study focused on the use of transseptal sheaths (TSS) for atrial fibrillation (AF) ablation, aiming to prevent thromboembolism through a simple saline flush management technique.
- In the retrospective study involving over 4,700 AF patients, complications were low, with no acute strokes, and only a few thromboembolic issues occurring post-procedure.
- The prospective study showed no thrombus formation in 127 procedures using high concentration heparinized saline, demonstrating that this method is both safe and effective for preventing thrombus during AF radiofrequency ablation.
CineECG Repolarization Gradients Predict Acute Hemodynamic Response in CRT Patients.
J Cardiovasc Electrophysiol
December 2024
Department of Cardiology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic.
Article Synopsis
- - The study investigates the effectiveness of a new ECG technique called CineECG, which visualizes heart electrical activity, in improving cardiac resynchronization therapy (CRT) for patients who don't respond well to standard treatments.
- - Researchers analyzed CineECG data from 15 patients with heart conditions under different pacing settings and found that specific movement directions in the heart's electrical signals correlate with better immediate heart performance (measured as dP/dt max).
- - The results indicate that the direction of the ST-T segment during repolarization can predict a significant improvement in heart function during CRT, suggesting that CineECG could help optimize treatment plans for patients.
The implementation of speckle tracking echocardiography for cardiac resynchronization therapy optimisation. A rotational myocardial mechanics interpretation.
Echo Res Pract
December 2024
1st Cardiology Department, General Hospital of Nikea, Agios Panteleimon, 3 D. Mantouvalou str., 18454, Athens, Greece.
Article Synopsis
- Cardiac resynchronization therapy (CRT) enhances left ventricular function in heart failure patients, but its mechanisms remain partly unclear; this study aimed to investigate these mechanisms using 2D speckle tracking echocardiography (2D-STE).
- The study involved 46 patients who underwent CRT and evaluated their cardiac performance at baseline and post-CRT implementation through 2D-STE and a 6-minute walk test, observing a 48% response rate at 6 months, particularly in those with dilated cardiomyopathy.
- Optimizing CRT by adjusting the activation timing of the ventricular electrodes was found to significantly improve left ventricular function, with improvements in effective stroke volume and rotational mechanics serving as key indicators of successful therapy
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