Hemodynamic Effects of Long-Term Cardiac Resynchronization Therapy

Steendijk, Paul; Tulner, Sven A.F.; Bax, Jeroen J.; Oemrawsingh, Pranobe V.; Bleeker, Gabe B.; Erven, Lieselot van; Putter, Hein; Verwey, Harriëtte F.; Wall, Ernst E. van der; Schalij, Martin J.

doi:10.1161/circulationaha.105.540435

Cited by 147 publications

(101 citation statements)

References 48 publications

(67 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Optimal LV filling also significantly improves LV systolic longitudinal dyssynchrony indices. Although longitudinal systolic dyssynchrony determined by pressure volume loops essentially differs from radial, circumferential or longitudinal dyssynchrony measured by echocardiography from a mechanistic point of view, pressure volume loops have been used to evaluate the effect of pacing on longitudinal dyssynchrony in several studies [5,11,14,18]. AV interval optimization results in an optimization in cardiac preload which in turn increases stroke volume, stroke work and cardiac output, while systolic and diastolic function of the heart remains unaltered.…”

Section: Discussionmentioning

confidence: 99%

“…Catheter position was verified by fluoroscopy and analysis of segmental volume signals [11]. The pressure volume catheter was coupled to a cardiac function lab (Leycom CFL512, CD Leycom), which digitizes pressure volume signals at a sample rate of 250 Hz.…”

Section: Protocolmentioning

confidence: 99%

“…The drawback of all these methods is that they are either investigator-dependent or have limited diagnostic accuracy. Pressure-volume loop analysis is an investigator independent method, which describes real-time LV function in a preload-independent fashion with high diagnostic accuracy [11]. The aim of this study was to analyze the effect of AV interval optimization in chronically implanted dual chamber pacemaker patients with maintained systolic LV-function.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

AV interval optimization using pressure volume loops in dual chamber pacemaker patients with maintained systolic left ventricular function

et al. 2012

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Protocolmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

AV interval optimization using pressure volume loops in dual chamber pacemaker patients with maintained systolic left ventricular function

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Acute hemodynamic response (AHR) is a reproducible marker of LV contractility best expressed as the change in the maximum rate of left ventricular pressure (LV-dP/dt max ), from a baseline control state [28,29]. Previous work has evaluated the acute hemodynamic effects of CRT using LV-dP/dt max as an outcome measure [29–32], and this metric has been used to compare the effects of biventricular (BiV) pacing at different locations [28,29,33]. An improvement in LV-dP/dt max of 10% during acute implantation has been shown to predict chronic LV reverse remodeling in patients receiving CRT [34].…”

Section: Acute and Chronic Markers Of Responsementioning

confidence: 99%

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Sieniewicz

Gould

Porter

et al. 2018

Expert Review of Medical Devices

View full text Add to dashboard Cite

Introduction: Cardiac resynchronization therapy (CRT) has emerged as one of the few effective treatments for heart failure. However, up to 50% of patients derive no benefit. Suboptimal left ventricle (LV) lead position is a potential cause of poor outcomes while targeted lead deployment has been associated with enhanced response rates. Image-fusion guidance systems represent a novel approach to CRT delivery, allowing physicians to both accurately track and target a specific location during LV lead deployment.Areas covered: This review will provide a comprehensive evaluation of how to define the optimal pacing site. We will evaluate the evidence for delivering targeted LV stimulation at sites displaying favorable viability or advantageous mechanical or electrical properties. Finally, we will evaluate several emerging image-fusion guidance systems which aim to facilitate optimal site selection during CRT.Expert commentary: Targeted LV lead deployment is associated with reductions in morbidity and mortality. Assessment of tissue characterization and electrical latency are critical and can be achieved in a number of ways. Ultimately, the constraints of coronary sinus anatomy have forced the exploration of novel means of delivering CRT including endocardial pacing which hold promise for the future of CRT delivery.

show abstract

“…While some reports found gender differences in outcomes for stable angina or acute coronary syndromes, others did not [11][12][13][14][15]. Furthermore, most contemporary studies of CAD patients are limited to a single country or specific geographical region, or a particular manifestation of disease such as angina symptoms or acute myocardial infarction [16][17][18].…”

mentioning

confidence: 99%

Women and men with stable coronary artery disease: different risk factors but similar outcomes!

Wall

2013

Neth Heart J

View full text Add to dashboard Cite

Men and women differ in terms of presentation and management in coronary artery disease (CAD). In recent years many clinical trials have provided evidence that there are substantial gender differences in the pathophysiology, clinical presentation, diagnosis, and treatment of CAD [1][2][3][4][5]. Although women have a higher atherosclerotic burden, they are more symptomatic and have a lower prevalence of obstructive CAD than men [6][7][8][9][10].Whether these gender differences translate into different clinical outcomes in stable CAD has been unclear. While some reports found gender differences in outcomes for stable angina or acute coronary syndromes, others did not [11][12][13][14][15]. Furthermore, most contemporary studies of CAD patients are limited to a single country or specific geographical region, or a particular manifestation of disease such as angina symptoms or acute myocardial infarction [16][17][18]. Recently, dr. Gabriel Steg et al. (Paris, France) analysed data from the international prospective CLARIFY registry to compare cardiovascular clinical outcomes in men and women with stable CAD [19]. CLARIFY (ProspeCtive observational LongitudinAl RegIstry oF patients with stable coronary arterY disease) is an ongoing international prospective observational longitudinal registry in 33,000 patients with stable CAD in 45 countries. One-year outcomes were analysed in 30,977 outpatients with stable CAD of whom 23,975 (77.4 %) were men and 7002 (22.6 %) were women. Based on risk profiles, women were older than men, were more likely to have hypertension and diabetes, did less exercise and smoked less. Women had more frequent angina, but were less likely to have undergone diagnostic non-invasive testing or coronary angiography. Women received less optimised treatment for stable CAD. However, 1-year outcomes were similar for men and women: 1) for the composite of cardiovascular death, non-fatal myocardial infarction, or stroke (1.7 vs. 1.8 %, respectively), 2) all-cause death (1.5 vs. 1.6 %), 3) fatal or non-fatal myocardial infarction (1.0 vs. 0.9 %,), and 4) cardiovascular death or non-fatal myocardial infarction (1.4 vs. 1.4 %,). Fewer women underwent revascularisation (2.6 vs. 2.2 %).It was concluded by the authors that, although the risk profiles of women and men with stable CAD differed substantially, the 1-year outcomes were similar in terms of mortality and cardiovascular events. These results suggest that there is no discernible excess of cardiovascular events in women with stable CAD compared with men and that, if anything, among younger patients or lower risk patient groups, women actually fare better than men.The study has been criticised by dr. Eva Swahn (Stockholm, Sweden) in an accompanying Editorial comment [20]. Her main critical comments were the following. First, the patients seem to be highly selected, as only 22.6 % were women and, according to epidemiological investigations, the prevalence is usually the same and in fact even slightly higher in women with angina. As the physicians involve...

show abstract

Hemodynamic Effects of Long-Term Cardiac Resynchronization Therapy

Cited by 147 publications

References 48 publications

AV interval optimization using pressure volume loops in dual chamber pacemaker patients with maintained systolic left ventricular function

AV interval optimization using pressure volume loops in dual chamber pacemaker patients with maintained systolic left ventricular function

Optimal site selection and image fusion guidance technology to facilitate cardiac resynchronization therapy

Women and men with stable coronary artery disease: different risk factors but similar outcomes!

Contact Info

Product

Resources

About