Treatment of cardiogenic shock with left ventricular assist device combined with cardiac resynchronization therapy: A case report

Keilegavlen, Havard; Nordrehaug, Jan Erik; Færestrand, Svein; Fanebust, Rune; Pettersen, Reidar J.; Haaverstad, Rune; Tuseth, Vegard

doi:10.1186/1749-8090-5-54

Cited by 12 publications

(7 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…12 Another case report described a 62-year-old patient with HF and cardiogenic shock requiring percutaneous LVAD (Impella) support that was successfully weaned after implantation of a CRT-D device. 13 Conversely, Choi et al, 24 who followed 35 LVAD patients (22 with CRT-D and 13 with ICD) over a short period (median 27 days for CRT-D and 6 days for ICD group), reported a higher occurrence of VA in the CRT-D group (64% vs 31% in the ICD group; P 5 .04) in the early posteLVAD implantation period. No long-term follow up data were reported.…”

Section: Discussionmentioning

confidence: 93%

“…11 Similarly, most patients with advanced cardiomyopathy and CRT-D who receive CF-LVADs continue to receive biventricular pacing after CF-LVAD implantation, with minimal data to support this practice. Case reports 12,13 suggest additive effects of biventricular pacing in improving outcomes in LVAD patients, but the long-term impact of continued CRT-D use on clinical outcomes in these patients remains unclear. Any benefit from CRT-D in CF-LVAD patients would be important to know, because this could affect outcomes and may aid myocardial recovery.…”

mentioning

confidence: 95%

See 1 more Smart Citation

Impact of Cardiac Resynchronization Therapy on Clinical Outcomes in Patients With Continuous-Flow Left Ventricular Assist Devices

Gopinathannair

Birks

Trivedi

et al. 2015

Journal of Cardiac Failure

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 93%

mentioning

confidence: 95%

Impact of Cardiac Resynchronization Therapy on Clinical Outcomes in Patients With Continuous-Flow Left Ventricular Assist Devices

Gopinathannair

Birks

Trivedi

et al. 2015

Journal of Cardiac Failure

View full text Add to dashboard Cite

“…Because of our limitations, we did not validate the results of our simulation with experimental data. In addition, we did not describe long-term effects such as recovery of cardiac functions by the combined CRT and LVAD, as previously described [ 28 , 29 ].…”

Section: Resultsmentioning

confidence: 99%

“…After such improvement, the patient successfully had the LVAD removed. In another case report article, the CRT and LVAD cooperatively restored the cardiac functions of a 62-year-old patient who had cardiogenic shock and left bundle branch block (LBBB) [ 29 ]. The report stated that the combination of CRT and LVAD performed a profound treatment on the weakening heart under LBBB condition.…”

Section: Introductionmentioning

confidence: 99%

Computational Prediction of the Combined Effect of CRT and LVAD on Cardiac Electromechanical Delay in LBBB and RBBB

Heikhmakhtiar

Lim

2018

Computational and Mathematical Methods in Medicine

View full text Add to dashboard Cite

Two case reports showed that the combination of CRT and LVAD benefits the end-stage heart failure patients with prolonged QRS interval significantly. In one of the reports, the patient had the LVAD removed due to the recovery of the heart function. However, the quantification of the combined devices has yet to be conducted. This study aimed at computationally predicting the effects of CRT-only or combined with LVAD on electromechanical behaviour in the failing ventricle with left bundle branch blocked (LBBB) and right bundle branch blocked (RBBB) conditions. The subjects are normal sinus rhythm, LBBB, RBBB, LBBB with CRT-only, RBBB with CRT-only, LBBB with CRT + LVAD, and RBBB with CRT + LVAD. The results showed that the CRT-only shortened the total electrical activation time (EAT) in the LBBB and RBBB conditions by 20.2% and 17.1%, respectively. The CRT-only reduced the total mechanical activation time (MAT) and electromechanical delay (EMD) of the ventricle under LBBB by 21.3% and 10.1%, respectively. Furthermore, the CRT-only reduced the contractile adenosine triphosphate (ATP) consumption by 5%, increased left ventricular (LV) pressure by 6%, and enhanced cardiac output (CO) by 0.2 L/min under LBBB condition. However, CRT-only barely affects the ventricle under RBBB condition. Under the LBBB condition, CRT + LVAD increased LV pressure and CO by 10.5% and by 0.9 L/min, respectively. CRT + LVAD reduced ATP consumption by 15%, shortened the MAT by 23.4%, and shortened the EMD by 15.2%. In conclusion, we computationally predicted and quantified that the CRT + LVAD implementation is superior to CRT-only implementation particularly in HF with LBBB condition.

show abstract

“…A few case reports suggest that the addition of CRT to selected patients with an LVAD might produce sufficient hemodynamic improvement to be lifesaving or to allow removal of the LVAD [16][17][18].…”

Section: Introductionmentioning

confidence: 98%

Electrical devices for left ventricular dysfunction and heart failure: do we need revised guidelines?

Guglin

Barold

2011

J Interv Card Electrophysiol

View full text Add to dashboard Cite

Three recent trials have demonstrated the benefit of cardiac resynchronization therapy (CRT) in the New York Heart Association (NYHA) class II patients with heart failure (HF) with ischemic or nonischemic cardiomyopathy as well as in NYHA class I (asymptomatic) patients mostly with ischemic cardiomyopathy. Earlier intervention with CRT in asymptomatic or minimally symptomatic patients improves survival and reduces HF hospitalizations. The reduction or the prevention of HF hospitalizations is of paramount importance because the HF episodes seem to alter the natural history of disease and are associated with deterioration of left ventricular (LV) function and a marked increase in mortality. The CRT benefit is greatest in patients with a QRS ≥ 150 ms. At this time, it would seem prudent to consider CRT-D (D = ICD) therapy for class I NYHA patients with a QRS ≥ 150 ms and an LV ejection fraction ≤ 30% regardless of etiology. Although the data for NYHA class I patients with nonischemic cardiomyopathy are scanty, the recommendation for class I patients is justified because CRT achieves a much greater degree of LV reverse remodeling in nonischemic compared to ischemic patients. With regard to lone ICDs, there is no evidence that they prevent sudden cardiac death more efficiently in symptomatic than in asymptomatic patients. Cardiomyopathy should be the primary target for device therapy regardless of symptoms for both CRT and lone ICD therapy. New guidelines are needed to address the role of CRT in hospitalized NYHA class IV HF patients or those who depend on inotropic therapy or an LV assist device because randomized CRT trials have not included these patients. CRT in these patients remains controversial. The mortality of such patients even with CRT is very high despite the occasional positive response. The role of CRT in patients waiting for cardiac transplantation also needs guidelines. With the expansion of CRT indications to minimally symptomatic or asymptomatic patients, the benefit of device therapy must be carefully weighed against the potential risk of lifelong device complications.

show abstract

Treatment of cardiogenic shock with left ventricular assist device combined with cardiac resynchronization therapy: A case report

Cited by 12 publications

References 8 publications

Impact of Cardiac Resynchronization Therapy on Clinical Outcomes in Patients With Continuous-Flow Left Ventricular Assist Devices

Impact of Cardiac Resynchronization Therapy on Clinical Outcomes in Patients With Continuous-Flow Left Ventricular Assist Devices

Computational Prediction of the Combined Effect of CRT and LVAD on Cardiac Electromechanical Delay in LBBB and RBBB

Electrical devices for left ventricular dysfunction and heart failure: do we need revised guidelines?

Contact Info

Product

Resources

About