Cardiac resynchronization therapy in patients with chronic heart failure: the view of a therapist, cardiologist

Abstract

The prevalence of the chronic heart failure is increasing due to the success of cardiology and the increase in life expectancy of the population. A greater number of patients live up to the clinically pronounced stages of the chronic heart failure. This issue leads to an increasing in the absolute number of the patients in whom there is a lack of efficacy of optimally prescribed drug therapy. These patients are considering initiating cardiac resynchronization therapy (CRT). CRT is recommended for the patients with chronic heart failure II-IV functional class with severe left ventricular systolic dysfunction and prolonged QRS complex. Despite careful selection of patients for CRT implantation, the device does not lead to the expected result in one third of cases. To increase the effectiveness of this intervention, the procedure should be performed in accordance with current guidelines only for compliant patients who have been at least 3 months on selected optimal drug therapy, should use the optimal strategies and modes of stimulation and the adequate drug support after the intervention. The number of patients with long-term use of CRT is constantly growing. More and more patients with installed devices come into the field of vision of general practitioners and cardiologists of ambulatory clinics and hospitals, for whom it is extremely important to understand the specifics of the methods and tactics of managing such patients. This publication is dedicated to this.

Evaluation of interventricular delay during cardiac resynchronization therapy in patients with quadripolar systems in long-term postoperative follow-up

“…Chumarnaya T. V. 1,3 , Lyubimtseva T. A. 1,2 , Lebedeva V. K. 2 , Gasimova N. Z. 2 , Lebedev D. S. 1,2 , Solovieva O. E. 1,3 Aim.…”

“…1,2 , Lebedeva V. K. 2 , Gasimova N. Z. 2 , Lebedev D. S. 1,2 , Solovieva O. E. 1,3 Aim. To assess the association between changes in interventricular delay (IVD) and response to cardiac resynchronization therapy (CRT) during 24-month postoperative period in patients with quadripolar left ventricular leads.…”

“…Сердечная ресинхронизирующая терапия (СРТ) хорошо зарекомендовала себя в качестве помощи пациентам с хронической сердечной недостаточ ностью (ХСН), у которых наблюдается систолическая дисфункция левого желудочка (ЛЖ) и увеличение QRSкомплекса (>130 мс). Множество крупных проспективных рандомизированных исследований подтвердили потенциал СРТ для улучшения качества жизни, снижения госпитализаций и смертности от ХСН [1,2]. Несмотря на достижения в технологии СРТ, значительное число (20-50%) пациентов считается "не ответившим" или "частично ответившим", в зависимости от критерия, применяемого для оценки успешности терапии [1,2].…”

“…Множество крупных проспективных рандомизированных исследований подтвердили потенциал СРТ для улучшения качества жизни, снижения госпитализаций и смертности от ХСН [1,2]. Несмотря на достижения в технологии СРТ, значительное число (20-50%) пациентов считается "не ответившим" или "частично ответившим", в зависимости от критерия, применяемого для оценки успешности терапии [1,2].…”