Biventricular pacing preserves left ventricular performance in patients with high-grade atrio-ventricular block: a randomized comparison with DDD(R) pacing in 50 consecutive patients

Albertsen, Andi Eie; Nielsen, Jens Cosedis; Poulsen, Steen Hvitfeldt; Mortensen, Peter Thomas; Pedersen, Anders Kirstein; Hansen, Peter S.; Jensen, Henrik Kjærulf; Egeblad, Henrik

doi:10.1093/europace/eun023

Cited by 62 publications

(35 citation statements)

References 33 publications

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“…Information from 9 trials comparing RV and biventricular pacing including a total of 1595 patients is shown in Table. 7-16 Four studies 7-10 (n=534) enrolled patients with AF after AVn ablation, and 5 studies [11][12][13][14][15][16] (n=1061) were conducted in patients with AVB.…”

Section: Randomized Clinical Trials Comparing Rv and Biventricular Pamentioning

confidence: 99%

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Routine Use of Biventricular Pacing Is Not Warranted for Patients With Heart Block

Arenas

Jacobson

Lamas

2015

Circ: Arrhythmia and Electrophysiology

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Section: Randomized Clinical Trials Comparing Rv and Biventricular Pamentioning

confidence: 99%

“…In this article, we review the physiological effects of RV pacing, data from observational studies ( Table I in the Data Supplement), [1][2][3][4][5][6] and available randomized trials comparing biventricular versus RV pacing (Table). [7][8][9][10][11][12][13][14][15][16] …”

mentioning

confidence: 99%

Routine Use of Biventricular Pacing Is Not Warranted for Patients With Heart Block

Arenas

Jacobson

Lamas

2015

Circ: Arrhythmia and Electrophysiology

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“…These studies have tested "de novo" CRT implantation in patients with a conventional pacing indication, both with preserved left ventricular systolic function [67][68][69] and with moderate-severe left ventricular dysfunction [70][71][72]. The results suggest that CRT plays a preventive role with regard to HF mortality/hospitalizations only in patients with left ventricular dysfunction (LVEF <40%).…”

Section: Patient Selectionmentioning

confidence: 99%

Six Sigma DMAIC for Shaking Stagnant Construction Cultures – A Conceptual Perspective

A¹

2015

J Civ Eng Environ Sci

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Heart Failure is the result of heterogeneous structural heart diseases, especially ischemic disease, and is becoming increasingly common in all Western countries.Many patients continue to be symptomatic in spite of progress in pharmacological therapy, and the risk of mortality remains high in the most advanced functional classes. Cardiac resynchronization therapy can be used as a therapeutic strategy for alleviating symptoms and reducing mortality in selected patients with heart failure.Cardiac resynchronization therapy provides both immediate and medium/long-term results. The immediate results are the reduced QRS duration, the synchrony restoration between the ventricles and between the lateral and septal walls of the left ventricle, the reduced mitral regurgitation and the increased stroke volume. In the medium/long term, left ventricular reverse remodeling occurs and left ventricular ejection fraction is increased.Several trials have documented both increased functional capacity and improvements in quality of life and New York Heart Association class. Moreover, cardiac resynchronization therapy has been seen to reduce HF hospitalizations and mortality and the total number of days of hospitalization.In order to reduce the percentage of non-responders to cardiac resynchronization therapy, it is necessary to optimize the prognostic stratification of candidates for implantation through multi-parameter evaluations and to ensure correct device programming with periodic updates which are widely recommended but not so often performed.Whether indications should be extended will need to be evaluated in view of the known complications mainly associated with lead implantation. RationaleIt is well known that QRS duration is inversely correlated with survival in HF patients in functional classes II-IV, and patients with QRS ≥200 ms have a 5-fold higher risk of death than those with a narrow QRS [7]. In particular, left bundle branch block (LBBB) usually delays activation of the posterior/lateral wall of the left ventricle, leading to asynchronous contraction between the septum and posterior-lateral wall and reducing the left ventricular ejection fraction (LVEF).CRT can correct this asynchronous contraction through the preexcitation of the posterior-lateral wall of the left ventricle, thereby improving systolic function [8,9]. Indeed, the dyssynchrony due to prolonged QRS duration involves the heterogeneous propagation of electrical activity in the ventricle, which determines various degrees of impaired coordination in filling and contraction [10]. Consequently the contractile efficiency of the heart is compromised and the myocardial oxygen consumption increases, worsening the clinical course of HF.

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“…Pequeños estudios aleatorizados han señalado que los pacientes con disfunción del VI moderada-grave podrían beneficiarse de la TRC en lugar de la estimulación apical del VD convencional (tabla 15) [123][124][125][126][127][128][129][130] . En general, los objetivos primarios de estos estudios se sustituyeron por objetivos hemodinámicos.…”

Section: Estimulación Cardiaca Con Terapia De Resincronización Cardiaunclassified

2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy

Brignole

Auricchio

Barón-Esquivias

et al. 2014

Revista Española de Cardiología (English Edition)

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Biventricular pacing preserves left ventricular performance in patients with high-grade atrio-ventricular block: a randomized comparison with DDD(R) pacing in 50 consecutive patients

Abstract: BiV pacing minimizes LV dyssynchrony, preserves LV function, and reduces NT-proBNP in contrast to DDD(R) pacing in patients with high-grade AV block.

Cited by 62 publications

References 33 publications

Routine Use of Biventricular Pacing Is Not Warranted for Patients With Heart Block

Routine Use of Biventricular Pacing Is Not Warranted for Patients With Heart Block

Six Sigma DMAIC for Shaking Stagnant Construction Cultures – A Conceptual Perspective

2013 ESC Guidelines on Cardiac Pacing and Cardiac Resynchronization Therapy

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