Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp hronic heart failure (HF) is associated with poor clinical outcomes. 1 In HF subjects, hyponatremia has been considered as important in terms of poor prognosis and is associated with plasma arginine vasopressin (AVP) secretion. 2-6 Moreover, cardiac resynchronization therapy (CRT) has played an important role in indicated HF subjects refractory to optimal medical therapy. 7-12 However, almost 30% of recipients show non-responsiveness, 7 which occasionally leads to subsequent HF events. In the past few years, various factors and physiological parameters such as electrocardiographic QRS duration, left bundle branch block and ischemic/non-ischemic cause associated with responsiveness/non-responsiveness to CRT have been explored. However, these parameters are indirect predictors for HF events as described above. To our knowledge, few have assessed the factors associated with HF events in patients receiving CRT. We explored the predictors among the baseline measurements, as well as conventional factors, for exacerbation of HF and with the baseline factors associated with responsiveness/non-responsiveness to CRT. Editorial p 47 Methods Study PopulationFrom August 2006 to February 2010, 83 consecutive chronic HF patients with an indication for CRT were eligible according to the guideline of the European Society of Cardiology; that is: New York Heart Association (NYHA) classification III or IV even with optimal medical therapy; left ventricular ejection fraction (LVEF) on echocardiogram <35%; QRS duration on electrocardiogram >120 ms. 8 Among them, a small number of patients with QRS duration <120 ms were included because of clinical necessity. Of the 83 eligible patients, 6 were excluded: 1 elderly bedridden woman who was transferred to other institution for long-term in-hospital rehabilitation, 1 bedridden elderly man with a tracheotomy and advanced lung disease who was similarly transferred for taking rehabilitation, and 4 patients with chronic kidney disease on regular hemodialysis. Background: Various factors associated with worsening heart failure (HF) events have been investigated in HF subjects. The purpose of this study was to identify the predictive factor(s) for worsening HF events after cardiac resynchronization therapy (CRT) among baseline parameters, as well as baseline factors associated with responsiveness or non-responsiveness to CRT. C Methods and Results:Seventy-seven HF patients with an indication for CRT were enrolled. Baseline parameters of blood chemistry, electrocardiogram, echocardiogram and cardiac catheterization before device implantation were measured, and subsequent clinical HF events after CRT were investigated. During the follow-up period (median 601 days), 22 of 77 (29%) recipients had HF events (unscheduled HF hospitalization: 16; use of left ventricular assist system: 1; heart transplantation: 1; cardiac death: 4). In the multivariate Cox proportional hazards model, low serum sodium concen...
1. With only 5.5% of patients having had pacemaker-related complications, the adverse outcome of APL is small. 2. Clinical clues to the possible occasion for pacemaker-related complications include three or more APLs, four or more total leads, three or more procedures of new lead placement, and a younger age at initial pacemaker implantation. 3. Patients with a large number of APLs, total lead implantations, and procedures of new lead placement should be carefully observed to detect possible pacemaker-associated complications.
The purpose of this study was to evaluate QRS width as an indication for cardiac resynchronization therapy. This study group consisted of 64 heart failure patients (51 men, age average 60.5 +/- 15.5 years) with a left ventricular ejection fraction (LVEF) of less than 35%. Patients were divided into two groups according to their QRS width; the wide QRS group (QRS width greater than or equal to 120 ms, 31 patients) and the narrow QRS group (QRS width less than 120 ms, 33 patients). The ventricular dyssynchrony (VD), i.e., the inter- and intraventricular dyssynchrony, of the two groups was compared. The correlation between QRS width and VD was evaluated in all patients. There were no significant differences between the wide and the narrow QRS groups concerning interventricular dyssynchrony [28.4 +/- 26.1 ms vs. 25.3 +/- 18.2 ms, not significant (NS)] or intraventricular dyssynchrony (99.0 +/- 43.8 ms vs. 109.0 +/- 56.6 ms, NS). Nor were there any differences in the LVEF (26.6 +/- 6.6% vs. 28.2 +/- 5.1%, NS), brain natriuretic peptide (BNP) (567.0 +/- 319.0 pg/ml vs. 390.0 +/- 375.8 pg/ml, NS), and New York Heart Association (NYHA) class (2.4 +/- 0.8 vs. 2.0 +/- 1.0, NS). QRS width did not correlate with interventricular (r = 0.026, NS) or intraventricular dyssynchrony (r = 0.052, NS). There were no differences in VD between the two groups based on differences in QRS width. There was also no correlation between QRS width and VD. It is suggested that QRS width is not an absolute indication for cardiac resynchronization therapy.
No abstract
No abstract
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
customersupport@researchsolutions.com
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.