Gauging the response to cardiac resynchronization therapy: The important interplay between predictor variables and definition of a favorable outcome

Petrović, Milan; Petrović, Marija; Milašinović, Goran; Tesic, B. Vujisic; Trifunović, D.; Petrović, Olga; Nedeljković, Ivana; Petrović, Ivana; Banović, Marko; Boričić-Kostić, Marija; Petrović, Jelena; Arena, Ross; Popović, Dejana

doi:10.1111/echo.13453

Cited by 3 publications

(3 citation statements)

References 22 publications

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“…The current study evaluated the long‐term impact of an active fixation LV lead in CS guided by electrical delay in patients with Heart Failure due to CAD. To date, a uniform definition of response to CRT is lacking, and in literature, there are often heterogeneous criteria 14 . For this reason, we assessed only the clinical response by objective assessment of death due to HF and rehospitalization for HF.…”

Section: Discussionmentioning

confidence: 99%

“…To date, a uniform definition of response to CRT is lacking, and in literature, there are often heterogeneous criteria. 14 For this reason, we assessed only the clinical response by objective assessment of death due to HF and rehospitalization for HF. A proper patient selection currently is recommended in order to maximize post‐procedural results.…”

Section: Discussionmentioning

confidence: 99%

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Novel active fixation lead guided by electrical delay can improve response to cardiac resynchronization therapy in heart failure

Casale¹,

Mezzetti²,

Fazio

et al. 2021

ESC Heart Failure

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Aims Cardiac resynchronization therapy (CRT) for heart failure (HF) recently has shown optimal results by targeting electrically delayed sites in coronary sinus (CS) branches. However this purpose often cannot be reached because of unstable left ventricular (LV) lead position. In current study were assessed the long‐term effects of the novel active fixation LV lead in CS, guided by electrical delay (QLV), in patients with HF due to coronary artery disease. Methods One hundred eighty‐five consecutive patients underwent CRT with intraoperative evaluation of QLV in the target position of the LV lead. When the novel active fixation LV lead was available, 98 consecutive patients received it, composing the Fix group. They were compared with 87 patients with a conventional passive fixation lead (No Fix group). The final LV lead position was assessed by fluoroscopy. Clinical response to CRT was assessed within a period of about 3 years: patients experiencing HF rehospitalization and death due to HF were defined as non‐responders. Results There were no significant differences between groups in the final position of LV lead in left anterior oblique view (Pearson χ2 = 0.12; P = 0.73). In right anterior oblique view, a basal position was reached more in the Fix group (38%) than in the No Fix group (6.5%) (Pearson χ2 = 23.095; P < 0.001). QLV was significantly greater in the Fix group (122.6 ± 33.2 ms; SE = 3.6) than in the No Fix group (97.5 ± 37.8 ms; SE = 4.9) (t = 4.17; P < 0.001). Rehospitalizations for HF were 37 in the No Fix group and 14 in the Fix group. Deaths due to HF were 49 in the No Fix group and 18 in the Fix group. Survival analysis, assessed by Cox regression, showed that the Fix group had a better outcome both for HF rehospitalizations [hazard ratio (HR) = 0.48; 95% confidence interval (CI) = 0.25–0.9; P = 0.023] and death due to HF (HR = 0.55; 95% CI = 0.31–0.97; P = 0.04) in comparison with the No Fix group. Adjustment for baseline characteristics by multivariate analysis showed that an active fixation lead in CS, as a covariate, was still significant both for HF rehospitalizations (HR 0.46; 95% CI = 0.24–0.88; P = 0.019) and for death due to HF (HR 0.5; 95% CI = 0.28–0.9; P = 0.021). Conclusions The novel active fixation LV lead allowed to target sites with greater QLV. Often maximum QLV was documented in basal segments, were stability of conventional passive fixation leads is not enough. Patients receiving it experienced less HF rehospitalizations and less death due to HF. Active fixation lead in CS guided by QLV can improve long‐term prognosis in patients with HF due to coronary artery disease undergoing to CRT.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Novel active fixation lead guided by electrical delay can improve response to cardiac resynchronization therapy in heart failure

Casale¹,

Mezzetti²,

Fazio

et al. 2021

ESC Heart Failure

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“…В качестве ключевого параметра ответа на РТ также рассматривалось увеличение ФВ ЛЖ до 20 % спустя год после РТ [44]. Поздний ответ на РТ (более 6 мес) в виде обратного ремоделирования ассоциирован с ишемической этиологией и ФК ХСН <III [45].…”

Section: патофизиологические аспекты и клинические эффекты метода ртunclassified

Resynchronization Therapy for Chronic Heart Failure: Diagnostic and Therapeutic Approaches

et al. 2019

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Chronic heart failure (CHF) remains one of the most important problems of modern cardiology. One of the effective treatment methods is resynchronization therapy (RT). The article presents an analysis of literature data on the effectiveness of RT in improving the quality of life, reducing the number of hospitalizations and mortality in patients with heart failure with severe left ventricular systolic dysfunction and expanding QRS complex, and also discusses key methods for optimizing RT.

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MiR-124 Regulates the Inflammation and Apoptosis in Myocardial Infarction Rats by Targeting STAT3

Cheng

Xin

2021

Cardiovasc Toxicol

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Gauging the response to cardiac resynchronization therapy: The important interplay between predictor variables and definition of a favorable outcome

Abstract: The definition of a favorable CRT response influenced the optimal predictor variable(s). Standardization of defining a favorable response to CRT is needed to guide clinical decision making processes.

Cited by 3 publications

References 22 publications

Novel active fixation lead guided by electrical delay can improve response to cardiac resynchronization therapy in heart failure

Novel active fixation lead guided by electrical delay can improve response to cardiac resynchronization therapy in heart failure

Resynchronization Therapy for Chronic Heart Failure: Diagnostic and Therapeutic Approaches

MiR-124 Regulates the Inflammation and Apoptosis in Myocardial Infarction Rats by Targeting STAT3

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