Electrical Resynchronization

Dubin, Anne M.; Feinstein, Jeffrey A.; Reddy, V. Mohan; Hanley, Frank L.; Hare, George F. Van; Rosenthal, David N.

doi:10.1161/01.cir.0000070930.33499.9f

Cited by 194 publications

(41 citation statements)

References 18 publications

(17 reference statements)

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“…Improvement of parameters used for evaluation of the LV function is observed: LVEF, end-diastolic volume, end-diastolic dimension, end--systolic volume and, end-systolic dimension [19]. CRT upgrades RV function which can be confirmed in the traditional echocardiographic examination by Tei-index and tricuspid annual systolic motion (TAPSE) evaluation [20][21][22][23]. The use of tissue Doppler imaging led to similar conclusions [24].…”

Section: Right Ventricular Function In Chronic Heart Failurementioning

confidence: 92%

The right ventricle in patients with chronic heart failure and atrial fibrillation

Majos

Dąbrowski²,

Szwed³

2013

Cardiol J

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Section: Right Ventricular Function In Chronic Heart Failurementioning

confidence: 92%

The right ventricle in patients with chronic heart failure and atrial fibrillation

Majos

Dąbrowski²,

Szwed³

2013

Cardiol J

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“…Asynchronous contraction in the areas of fibrotic tissue acts as a substrate for late arrhythmias through QRS prolongation, as stated previously. Cardiac resynchronization therapy could serve as a treatment strategy for regional asynchronous RV contraction [60].…”

Section: Qrs Prolongationmentioning

confidence: 99%

Late arrhythmia in patients with repaired tetralogy of Fallot: who is at risk?

Grigaliūnas

Gumbienė

Valevičienė

et al. 2015

Seminars in Cardiovascular Medicine

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SummaryTetralogy of Fallot (TOF) is the most common cause of cyanotic congenital heart defect. Over the last century, the life expectancy of TOF patients has significantly improved. This, however, has brought new challenges both to patients and their health-care providers, the main of them being late arrhythmia. Ironically, late arrhythmia is predominantly generated due to the fibrotic scars caused by the life-saving surgical repair. Once the first two mainly arrhythmia-free decades after the repair pass, the risk of developing late arrhythmia and, therefore, SCD becomes substantial. Consequently, young adults with repaired Tetralogy of Fallot (rTOF) require careful outpatient monitoring.There have been many attempts to predict the risk of life-threatening arrhythmia in rTOF patients. This has led to the defining of various risk factors, ranging from the widely used QRS prolongation to novel predictors, derived from cardiac magnetic resonance (CMR) based anatomical findings (left ventricular dyssynchrony indexes, right ventricular output tract akinetic length, right ventricular mass-to-volume ratio). The latter predictors have recently established CMR as a tool of high significance in evaluation of rTOF patients.Although the role of Holter monitoring findings in rTOF patient-assessment remains unclear, it may be useful in those who are 25 years and older. Implantable cardioverter-defibrillator (ICD) implantation is the first-line treatment for secondary prevention of sudden cardiac death (SCD). rTOF patients suffer from the highest rate of inappropriate and the lowest rate of appropriate ICD shocks, when compared to other congenital heart diseases. As a consequence, ICD implantation for primary SCD prevention should be carefully weighed. Catheter-based ablation therapy leads to high rate of initial success when abolishing monomorphic ventricular tachycardia and intra-atrial reentrant tachycardia, however recurrence rates remain high. Seminars in Cardiovascular Medicine

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“…[31][32][33] Although it is not definitively clear whether it is better to pace the RV or the LV first, it is evident that nonsimultaneous pacing improves cardiac hemodynamics in the face of RV dysfunction. [31][32][33] Clinical benefits were demonstrated for patients with right heart dysfunction [34][35][36] with or without a pre-existing right bundle branch block. 34,35 For those with a right bundle branch block, pacing the RV first narrowed the QRS and improved RV dP/dt and systemic hemodynamics.…”

Section: Lv-rv Interaction and The Ivsmentioning

confidence: 99%

“…[31][32][33] Clinical benefits were demonstrated for patients with right heart dysfunction [34][35][36] with or without a pre-existing right bundle branch block. 34,35 For those with a right bundle branch block, pacing the RV first narrowed the QRS and improved RV dP/dt and systemic hemodynamics. 34,35 Importantly, the benefit of the IVS is due not only to movement but also to contractility and the overall systolic performance of the LV, which, when increased, can produce a more vigorous movement of the IVS toward the right.…”

Section: Lv-rv Interaction and The Ivsmentioning

confidence: 99%

“…34,35 For those with a right bundle branch block, pacing the RV first narrowed the QRS and improved RV dP/dt and systemic hemodynamics. 34,35 Importantly, the benefit of the IVS is due not only to movement but also to contractility and the overall systolic performance of the LV, which, when increased, can produce a more vigorous movement of the IVS toward the right. Inactivation or akinesis of the IVS in models of RV dysfunction results in a 30-40% reduction in RV performance (RV dP/dt).…”

Section: Lv-rv Interaction and The Ivsmentioning

confidence: 99%

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Case report: paradoxical ventricular septal motion in the setting of primary right ventricular myocardial failure

Maslow

Schwartz

Mahmood

et al. 2009

Can J Anesth/J Can Anesth

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Purpose In this report, a case of right ventricular (RV) failure, hemodynamic instability, and systemic organ failure is described to highlight how paradoxical ventricular systolic septal motion (PVSM), or a rightward systolic displacement of the interventricular septum, may contribute to RV ejection. Clinical features Multiple inotropic medications and vasopressors were administered to treat right heart failure and systemic hypotension in a patient following combined aortic and mitral valve replacement. In the early postoperative period, echocardiographic evaluation revealed adequate left ventricular systolic function, akinesis of the RV myocardial tissues, and PVSM. In the presence of PVSM, RV fractional area of contraction was C35% despite akinesis of the primary RV myocardial walls. The PVSM appeared to contribute toward RV ejection. As a result, the need for multiple inotropes was re-evaluated, in considering that end-organ dysfunction was the result of systemic hypotension and prolonged vasopressor administration. After discontinuation of phosphodiesterase inhibitors, native vascular tone returned and the need for vasopressors declined. This was followed by recovery of systemic organ function. Echocardiographic re-evaluation two years later, revealed persistent akinesis of the RV myocardial tissues and PVSM, the latter appearing to contribute toward RV ejection. Conclusions This case highlights the importance of left to RV interactions, and how PVSM may mediate these hemodynamic interactions. RésuméObjectif Dans ce compte-rendu, un cas de de´faillance ventriculaire droite (VD), d'instabilite´he´modynamique et de de´faillance organique syste´mique est de´crit afin de souligner la manie`re dont le mouvement systolique paradoxal du septum interventriculaire (PVSM), ou un de´placement systolique de la cloison interventriculaire vers la droite, peut jouer un rôle dans l'e´jection du VD. É léments cliniques De nombreux me´dicaments inotropes et vasopresseurs ont e´te´administre´s pour traiter une de´faillance cardiaque droite ainsi qu'une hypotension syste´mique chez un patient a`la suite d'une chirurgie valvulaire aortique et mitrale combine´e. Au de´but de la pe´riode postope´ratoire, l'e´valuation e´chocardiographique a re´ve´le´une fonction systolique ade´quate du ventricule Electronic supplementary material The online version of this article

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Electrical Resynchronization

Cited by 194 publications

References 18 publications

The right ventricle in patients with chronic heart failure and atrial fibrillation

The right ventricle in patients with chronic heart failure and atrial fibrillation

Late arrhythmia in patients with repaired tetralogy of Fallot: who is at risk?

Case report: paradoxical ventricular septal motion in the setting of primary right ventricular myocardial failure

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