Optimization of right ventricular lead position in cardiac resynchronisation therapy☆

Riedlbauchová, Lucie; Ĉihaák, Robert; Bytešník, Jan; Vančura, V.; Frídl, P; Hoŝkovaá, Lenka; Kautzner, Josef

doi:10.1016/j.ejheart.2005.11.009

Cited by 46 publications

(31 citation statements)

References 23 publications

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“…Some studies corroborate the results presented 9,10 . Right ventricular (RV) lead implantation in the RV outflow tract was performed in three patients of the BV group, aiming at optimizing the ventricular resynchronization, a technique that is supported by some authors 25 .…”

Section: Discussionmentioning

confidence: 99%

Ressincronização ventricular: comparando os marcapassos biventriculares com os marcapassos bifocais de ventrículo direito

Rocha¹,

Gondim²,

Abreu³

et al. 2007

Arq. Bras. Cardiol.

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SummaryObjective: To analyze the conventional biventricular pacing (BV) and the bifocal (BF) right ventricular (RV) pacing, and to perform a comparative analysis of these two techniques in relation to clinical, functional and echocardiographic parameters in a population without the exclusion criteria of the major studies.Methods: A prospective non-randomized analysis of 36 patients undergoing surgery for multisite pacemaker implantation due to QRS ≥ 130 ms, severe left ventricular dysfunction, and NYHA functional class III or ambulatory class IV congestive heart failure was performed.Results: Favorable results of resynchronization were obtained with both techniques, with no significant differences in the comparison of the two groups, except for a higher QRS narrowing in the BV group, and a trend of a lower number or hospital admissions in the BV group. When the groups were analyzed separately and compared before and after the procedures, we observed that improvement was much more significant in the biventricular group, as were the more statistically relevant rates.Conclusion: Cardiac resynchronization therapy proved to be an efficient therapy in both groups analyzed, although with more significant outcomes in the biventricular group. (Arq Bras Cardiol 2007;88(6):596-603)

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Section: Discussionmentioning

confidence: 99%

Ressincronização ventricular: comparando os marcapassos biventriculares com os marcapassos bifocais de ventrículo direito

Rocha¹,

Gondim²,

Abreu³

et al. 2007

Arq. Bras. Cardiol.

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“…24 In their study, the implantation of the RV leads was guided by measuring intervals between RV and LV electrograms. Because the methods used in our study for determining the RV pacing site were similar to those of Lucie et al, we expect that LV end-diastolic diameter as a sign of LV reverse remodeling will show a more significant reduction in response to BVP using the RV midseptum than to BVP positioned in the RVA.…”

Section: Hemodynamic Assessment Of the Rvot And Rv Mid-septummentioning

confidence: 99%

Identification of the Right Ventricular Pacing Site for Cardiac Resynchronization Therapy (CRT) Guided by Electroanatomical Mapping (CARTO)

Kiuchi

Yoshida

Fukuzawa

et al. 2007

Circ J

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“…50 Several small studies have shown conflicting results regarding the effect of RV lead position (RV midseptal position versus RV apex) in CRT. 51,52 CARDIAC RESYNCHRONIZATION FOR THE FAILING RIGHT VENTRICLE There is preliminary evidence that resynchronization therapy may be beneficial for RV failure in the setting of increased afterload. Studies to date have been focused on animal models of pulmonary arterial hypertension and on patients with congenital heart disease and chronic thromboembolic pulmonary hypertension.…”

Section: Cardiac Resynchronization For Left Ventricular Failurementioning

confidence: 99%

“…Exactly why some patients do not respond to CRT is not completely understood; however, evidence suggests that baseline RV function and, potentially, the location of RV pacing play important roles in responsiveness to CRT. [50][51][52] Poor baseline right ventricular function as assessed by TAPSE has been shown to correlate to reduction in LV end-systolic volume following initiation of CRT, indicating baseline RV function is a relevant predictor of CRT response. 50 Several small studies have shown conflicting results regarding the effect of RV lead position (RV midseptal position versus RV apex) in CRT.…”

Section: Cardiac Resynchronization For Left Ventricular Failurementioning

confidence: 99%

Is Cardiac Resynchronization Therapy for Right Ventricular Failure in Pulmonary Arterial Hypertension of Benefit?

et al. 2014

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Pulmonary arterial hypertension is a manifestation of a group of disorders leading to pulmonary vascular remodeling and increased pulmonary pressures. The right ventricular (RV) response to chronic pressure overload consists of myocardial remodeling, which is in many ways similar to that seen in left ventricular (LV) failure. Maladaptive myocardial remodeling often leads to intraventricular and interventricular dyssychrony, an observation that has led to cardiac resynchronization therapy (CRT) for LV failure. CRT has proven to be an effective treatment strategy in subsets of patients with LV failure resulting in improvement in LV function, heart failure symptoms, and survival. Current therapy for pulmonary arterial hypertension is based on decreasing pulmonary vascular resistance, and there is currently no effective therapy targeting the right ventricle or maladaptive ventricular remodeling in these patients. This review focuses on the RV response to chronic pressure overload, its effect on electromechanical coupling and synchrony, and how lessons learned from left ventricular cardiac resynchronization might be applied as therapy for RV dysfunction in the context of pulmonary arterial hypertension.Keywords: pulmonary hypertension, pulmonary arterial hypertension, right ventricular failure, dyssynchrony, cardiac resynchronization therapy. Pulmonary arterial hypertension is a manifestation of a group of disorders that cause pulmonary vascular remodeling, alterations in pulmonary vascular resistance, and reduced compliance. Ultimately, increased pulmonary pressures may induce alterations in right ventricular structure and function. Current therapy is largely based on targeting biochemical pathways to decrease pulmonary vascular resistance. Despite this, the final common pathway for many patients remains right ventricular failure and death. Although left ventricular (LV) failure has been well characterized, leading to multiple therapies with proven mortality benefit, less is known about the failing right ventricle (RV). In fact, early evaluation of the role of RV function in disease states (i.e., RV free wall infarction/ ablation, Fontan physiology, or lung transplantation) suggested that the RV was highly adaptable and perhaps superfluous to overall cardiac function in the absence of sustained pulmonary arterial hypertension. However, recent improvements in imaging and technology, including strain imaging, tissue Doppler imaging (TDI), and magnetic resonance imaging (MRI) have led to a better understanding of the adaptation of the RV to chronic pressure overload.Many similarities between RV and LV failure have been observed, including changes in mechanical function, RV global and myocyte structure and function, 2 myocardial blood flow, 3 and electrophysiologic properties. 4 In a limited number of mechanical interventions in the pulmonary circulation (lung transplantation and pulmonary artery endarterectomy), RV reverse remodeling has been noted, suggesting a reversible component to RV remodeling related t...

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Optimization of right ventricular lead position in cardiac resynchronisation therapy☆

Cited by 46 publications

References 23 publications

Ressincronização ventricular: comparando os marcapassos biventriculares com os marcapassos bifocais de ventrículo direito

Ressincronização ventricular: comparando os marcapassos biventriculares com os marcapassos bifocais de ventrículo direito

Identification of the Right Ventricular Pacing Site for Cardiac Resynchronization Therapy (CRT) Guided by Electroanatomical Mapping (CARTO)

Is Cardiac Resynchronization Therapy for Right Ventricular Failure in Pulmonary Arterial Hypertension of Benefit?

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