Cardiac resynchronization by pacing: an electrical treatment of heart failure

Boriani, Giuseppe; Biffi, Mauro; Martignani, Cristian; Fallani, Francesco; Greco, Cristiano; Grigioni, Francesco; Corazza, Ivan; Bartolini, Pietro; Rapezzi, Claudio; Zannoli, Romano; Branzi, Angelo

doi:10.1016/j.ijcard.2003.05.016

Cited by 39 publications

(26 citation statements)

References 79 publications

(108 reference statements)

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“…20,21) Right ventricular apical pacing, even in DDD(R) pacing mode, produces wide QRS complexes and forms artificial left bundle branch block, which will lead to uncoordinated cardiac contractions and bring about Vol 46 No 6 adverse hemodynamic effects, which are more apparent in patients with significant cardiac dysfunction. 22,23) This study has two limitations. First, the patient population was rather small.…”

Section: Discussionmentioning

confidence: 95%

<b>Blood B-Type Natriuretic Peptide Changes in Different Periods and Different Cardiac Pacing Modes</b>

Wang

Wen-ping

et al. 2005

Int. Heart J.

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SUMMARYTo observe blood B-type natriuretic peptide (BNP) level changes and the clinical implications in different periods and different cardiac pacing modes, the BNP levels of 105 patients with permanent cardiac pacing were assayed before pacemaker implantation and 1 day, 1 week, 1 month, 3 months, 6 months, and 9 months postoperatively. BNP level changes were compared in different periods and during different pacing modes. DDD(R) pacing mode was performed in 32 patients for 9 months and then changed to AAI(R) and VVI(R) pacing modes for 2 months, respectively. BNP levels were assayed during three different pacing modes.BNP levels did not change at any time with any pacing mode in patients with New York Heart Association (NYHA) heart functional class I to II before pacemaker implantation, however, BNP levels did change significantly with physiologic pacing mode and nonphysiologic pacing mode in patients with NYHA heart functional class III to IV before pacemaker implantation. BNP levels during physiologic pacing mode decreased significantly while it increased during nonphysiologic pacing mode. BNP levels were the lowest in AAI(R) pacing and the highest in VVI(R) pacing among the three pacing modes. The BNP level in DDD(R) pacing was between that for AAI(R) pacing and VVI(R) pacing.The results indicate that physiologic pacing should first be chosen in patients with bradycardia and congestive heart failure (CHF), and that AAI(R) was the best pacing mode if atrioventricular conduction function was normal. (Int Heart J 2005; 46: 1015-1022 Key words: B-type natriuretic peptide, Pacing mode, Congestive heart failure, Physiologic pacing, Nonphysiologic pacing IN recent years, the indications of cardiac pacing have expanded continuously with the rapid development of pacing techniques. Pacemaker treatment is not only limited to arrhythmias of bradycardia and the number of pacemaker treatments has increased year by year. However, more and more cases of new congesFrom the

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Section: Discussionmentioning

confidence: 95%

<b>Blood B-Type Natriuretic Peptide Changes in Different Periods and Different Cardiac Pacing Modes</b>

Wang

Wen-ping

et al. 2005

Int. Heart J.

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“…Nevertheless, our study supports the role of this straightforward, economical bedside tool for Ffirst-look' monitoring of the effects of CRT (which can then be investigated when appropriate in greater detail by a focused echocardiographic evaluation of LV reverse remodeling). The large number of potential candidates to CRT [2] could make this approach particularly attractive in clinical practice. In the present study, the acute effects of shifting from BiV pacing to the other pacing modalities provide indications as to how the Fsensitivity' of the QRS interval (i.e.…”

Section: Discussionmentioning

confidence: 99%

“…This treatment is able to improve symptoms, functional capacity, quality of life, and also reduces hospitalization and mortality [1 -4]]. A wide QRS (> 120 ms) has traditionally been considered a key requirement for selecting candidates to this treatment, and biventricular (BiV) pacing is usually associated with a narrowing of QRS [2,3]. Because around 30% of patients do not respond to CRT, much interest is being focused on the possibility of identifying responders by means of clinical, echocardiographic or electrocardiographic (ECG) parameters [1,2].…”

Section: Introductionmentioning

confidence: 99%

Electrocardiographic remodeling during cardiac resynchronization therapy

Boriani

Biffi

Martignani

et al. 2006

International Journal of Cardiology

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“…108 -110 Clearly, future studies are needed to determine whether mutations or expression changes in human IRX3 gene contribute to ventricular conduction disturbances in heart disease. It is important to appreciate that ECG abnormalities, particularly in association with BBB, 111 are key criteria in selecting patients for ventricular resynchronization and defibrillation therapy, [112][113][114] which, while alleviating and reversing disease symptoms, 115,116 dismally affect long-term disease outcome in advanced heart disease. 117,118 These observations emphasize the need to better understand the mechanisms underlying abnormal conduction in the setting of advanced heart disease.…”

Section: Relationship Of Irx Genes To Cardiovascular Diseasementioning

confidence: 99%

Iroquois Homeodomain Transcription Factors in Heart Development and Function

Kim

Rosén²,

Bruneau³

et al. 2012

Circulation Research

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Numerous cardiac transcription factors play overlapping roles in both the specification and proliferation of the cardiac tissues and chambers during heart development. It has become increasingly apparent that cardiac transcription factors also play critical roles in the regulation of expression of many functional genes in the prenatal and postnatal hearts. Accordingly, mutations of cardiac transcription factors cannot only result in congenital heart defects but also alter heart function thereby predisposing to heart disease and cardiac arrhythmias. In this review, we summarize the roles of Iroquois homeobox (Irx) family of transcription factors in heart development and function. In all, 6 Irx genes are expressed with distinct and overlapping patterns in the mammalian heart. Studies in several animal models demonstrate that Irx genes are important for the establishment of ventricular chamber properties, the ventricular conduction system, as well as heterogeneity of the ventricular repolarization Key Words: Iroquois homeobox Ⅲ cardiac transcription factor Ⅲ cardiac development T he heart is the first functional organ formed in the mammalian embryo in order to provide the necessary nutrients for growth and development. 1 Throughout life, the contraction sequence of the heart in each beat is orchestrated by well-defined electric activation patterns designed to enable efficient mechanical pumping of blood. Electric impulses begin in the auto-rhythmic cells of the sinoatrial node and propagate to the atria, thereby initiating contraction and blood propulsion into the relaxed and compliant ventricles. The electric impulses then proceed with highly controlled delay to the ventricles via the specialized ventricular conduction system (VCS), comprising sequentially the atrioventricular node, His bundles, left and right bundle branches, and Purkinje fiber network. Electrical stimulation of the VCS ultimately results in highly ordered ventricular contractions proceeding from the apex toward the base as well as from the endomyocardium to epimyocardium, 2,3 thus enabling efficient blood ejection into the systemic and pulmonary circulations. The ventricles then repolarize and relax in reverse order from epimyocardium to endomyocardium and from the base toward the apex.Efficient heart function requires the precise and harmonious union of structure and function, which is achieved by precisely controlled patterns of gene expression within different cardiac regions at developmental stages. For example, in the early embryo, cardiac transcription factors (TFs) such as Nkx2-5, 4 Gata, 5 Hand, 6 Nfat, 7 and the T-box family members 8 regulate many key aspects of heart development, including cardiac chamber septation, valve formation, and outflow tract morphogenesis. Consequently, mutations in these TFs are directly associated with several congenital heart diseases. 9 On the other hand, some of these same genes control expression of key functional genes regulating contractile and electric properties of the mature heart. 10 -13...

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Cardiac resynchronization by pacing: an electrical treatment of heart failure

Cited by 39 publications

References 79 publications

<b>Blood B-Type Natriuretic Peptide Changes in Different Periods and Different Cardiac Pacing Modes</b>

<b>Blood B-Type Natriuretic Peptide Changes in Different Periods and Different Cardiac Pacing Modes</b>

Electrocardiographic remodeling during cardiac resynchronization therapy

Iroquois Homeodomain Transcription Factors in Heart Development and Function

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