Optimized resynchronization in heart failure patients with IVCD produces marked acute improvement of the altered cardiac cycle timing. The variability of Doppler parameters with different CRT modalities underlines the necessity of individualized settings and suggests that the patients' benefit may be jeopardized without optimization.

Patients after TAVI benefit from cardiac rehabilitation despite their older age and comorbidities. CR is a helpful tool to maintain independency for daily life activities and participation in socio-cultural life.

Background: Cardiac resynchronization therapy (CRT) reduces the left ventricular diameter (LVEDD) in heart failure (HF) patients with left bundle branch block (LBBB). 27). QRS increased in both groups (CRT bl 165 ± 22 vs fup 171 ± 20 ms, P = 0.07, controls bl 111 ± 17 vs fup 118 ± 19 ms, P = 0.01). Analyses revealed no significant association of echocardiographic and ECG parameters. Conclusions: Despite LVEDD reduction with CRT, electrical activation does not recover. Electrical remodeling does not differ between LBBB patients under CRT and matched controls without CRT indication. (PACE 2008; 31:70-77) cardiac resynchronization, electrical remodeling, structural remodeling, QRS width, left ventricular diameter IntroductionDelayed cardiac electrical activation including prolongation of the PR interval and the QRS duration is common in patients suffering from severe systolic heart failure.1-3 The conduction disturbance may be caused by ischemic heart disease and may result from circumscript myocardial necroses involving the specific ventricular conduction system 4 or from large infarcted areas with more extensive damage of the myocardium and the conduction system. Dilated cardiomyopathy is also frequently associated with delayed and prolonged ventricular activation. QRS duration and left ventricular ejection fraction (LVEF) are known to be inversely correlated. [2][3][4][5] The vast majority of patients with wide QRS concomitantly exhibit ven-

Left ventricular pre-ejection interval and IVMD predict favourable LV remodelling on CRT. The additional application of tissue Doppler parameters may further increase specificity and negative predictive value.

Extraordinarily favorable reverse LV remodeling through CRT in CHF and LBBB appears to require a particularly dilated LV due to nonischemic heart disease with pronounced electromechanical alteration, but with a fairly preserved functional capacity before CRT.

The long-term mortality in this unselected population of ICD recipients was low. Patients treated for secondary prevention received earlier appropriate ICD therapy than patients treated for primary prevention. Long-term mortality was similar in both groups. The higher VT incidence of VTA was effectively treated by the ICD and was not associated with a higher mortality.

Frequent RVP is associated with impaired survival in ICD patients despite conservative pacing settings. Implantable cardioverter/defibrillator patients requiring concomitant bradycardia pacing should be cared for with particular attention to clinical worsening. Right ventricular pacing prevention and alternative modalities of ventricular pacing need prospective evaluation.

The results do not support a major overlap between the genetic risk of AD and the genetic risk of cerebrovascular disease, Down's syndrome, haematological malignancies or Parkinson's disease. The finding of an increased risk of congenital malformations in relatives of AD patients needs further replication before it can be stated. The increased risk of dementia or depression with cognitive impairment in elderly relatives of patients with AD or MD increases the risk of accidents like falls. The genetic risk of depression in relatives of patients with MD could have a negative influence on the prognosis of peptic ulcera.