Prediction of response to cardiac resynchronization therapy using simple electrocardiographic and echocardiographic tools

Bonakdar, Hamid Reza; Jorat, Mohammad Vahid; Fazelifar, Amir Farjam; Alizadeh, Abolfath; Givtaj, Nozar; Sameie, Niloofar; Sadeghpour, Anita; Haghjoo, Majid

doi:10.1093/europace/eup258

Cited by 49 publications

(34 citation statements)

References 28 publications

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“…This is in keeping with findings of other studies. 28,29 Bonakdar and colleague also found baseline QRS >145ms to be an independent predictor of CRT response with the best sensitivity and specificity. 29 …”

Section: Figure 5 Discussionmentioning

confidence: 91%

Coupling of ventricular action potential duration and local strain patterns during reverse remodeling in responders and nonresponders to cardiac resynchronization therapy

et al. 2016

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Coupling of ventricular action potential duration and local strain patterns during reverse remodeling in responders and non-responders to cardiac resynchronization therapy, Heart Rhythm, http://dx.doi. org/10.1016/j.hrthm.2016.06.014 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting galley proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

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Section: Figure 5 Discussionmentioning

confidence: 91%

Coupling of ventricular action potential duration and local strain patterns during reverse remodeling in responders and nonresponders to cardiac resynchronization therapy

et al. 2016

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“…Widening of the QRS after CRT implantation has been found to be an independent predictor of mortality or progression to heart transplantation[103], and achieving a reduction in the paced QRS has been shown to predict response in several studies [104] including via multivariate logistic regression [105]. In other work, a reduction in paced QRSd was found to be the only predictor of response [106].…”

Section: Identifying the Site Of Latest Electrical Activation (Lea)mentioning

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

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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.

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“…Bonakdar et al 17 described that not only baseline QRS duration but also QRS narrowing immediately after CRT can predict long-term response. In addition, acute hemodynamic improvement post-implant might predict long-term responders 17 .…”

Section: Crt Responders and Non-respondersmentioning

confidence: 99%

Usefulness of Intracardiac Local Ventricular Electrogram to Predict Responders in Patients Undergoing Cardiac Resynchronization Therapy

:筆頭著者¹,

:責任著者²,

Yoshikawa³

et al. 2017

Showa Univ J Med Sci

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: Cardiac resynchronization therapy CRT is a well-established, ef cient strategy for medically-refractory congestive heart failure HF with ventricular conduction disturbances. However, about 30 of patients who undergo CRT do not receive any bene t. Therefore, we investigated the usefulness of the QRS-left ventricle LV interval for predicting responders during CRT implantation. This study included 66 patients who underwent CRT implantation. The de nition of responder was a ≥ 15 reduction in LV end-systolic volume or ≥ 20 increase in LV ejection fraction. The QRS-LV interval was measured from the beginning of the body surface electrocardiogram QRS complex to the LV potential recorded by LV leads. We analyzed the correlations between the QRS-LV intervals and CRT responders, admission for HF and mortality. The patients were 67 12 years old, and their mean LV ejection fraction was 26.3 8.3 . During follow-up 27.2 19.9 months , 27 patients were admitted for HF 40.1 , and 17 died 25.7 ; the median QRS-LV interval was 103 33 msec. Patients were divided into 2 groups: wide QRS-LV 103 msec , and narrow QRS-LV 103 msec . The wide QRS-LV group had a lower mortality rate than the narrow QRS-LV group 77 vs. 53 , P 0.05 . In patients with dilated cardiomyopathy, the QRS-LV interval was signi cantly wider in responders, compared to non-responders 112 9.2 vs. 80.0 10 msec, P 0.05 . The QRS-LV interval did not correlate with CRT responders or admission for HF. The mortality rate was lower in patients with wide QRS-LV intervals, compared to narrow QRS-LV intervals. Furthermore, a wide QRS-LV interval might be a predictor for CRT responders in patients with dilated cardiomyopathy.

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Prediction of response to cardiac resynchronization therapy using simple electrocardiographic and echocardiographic tools

Abstract: A positive response to CRT was observed in 68% of the patients. Cardiac resynchronization therapy response is predictable using simple electrocardiographic and echocardiographic data.

Cited by 49 publications

References 28 publications

Coupling of ventricular action potential duration and local strain patterns during reverse remodeling in responders and nonresponders to cardiac resynchronization therapy

Coupling of ventricular action potential duration and local strain patterns during reverse remodeling in responders and nonresponders to cardiac resynchronization therapy

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

Usefulness of Intracardiac Local Ventricular Electrogram to Predict Responders in Patients Undergoing Cardiac Resynchronization Therapy

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