Echocardiography‐ versus intracardiac electrocardiogram‐based optimization of cardiac resynchronization therapy: A systematic review

Sami, Abdul; Mustafa, Bilal; Butt, Hamza; Ashraf, Zainab; Ullah, Asif; Babar, Farheen; Asad, Muhammad; Awais, Muhammad; Zaidi, Syed Muhammad Jawad; Fakhar, Tehniat; Malik, Jahanzeb; Adnan, Nawal

doi:10.1111/anec.13040

Cited by 4 publications

(5 citation statements)

References 52 publications

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“…CRT is a well-known guideline-based therapy that can provide LV synchrony through electrical resynchronization (Sami et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

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Efficacy and safety of cardiac resynchronization therapy in chemotherapy‐induced cardiomyopathy: A systematic review

Shehram,

Khalid,

Shafique

et al. 2023

Noninvasive Electrocardiol

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ObjectiveThe aim of the study was to assess the efficacy of cardiac resynchronization therapy (CRT) in patients with chemotherapy‐induced cardiomyopathy (CIC).MethodsWith the increasing incidence of CIC, the association of CRT with improvement in clinical outcomes, echocardiographic parameters, and New York Heart Classification (NYHA) class was assessed through this qualitative systematic review.ResultsThe five studies included a total of 169 patients who underwent CRT after CIC, and of these, 61 (36.1%) patients were males. All studies showed an improvement in left ventricular ejection fraction (LVEF), among other echocardiographic parameters of LV volume. However, these findings are limited by short follow‐up periods, small sample sizes, and the absence of a control group.ConclusionCRT was associated with improvement in all patient parameters with CIC.

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“…CRT is a well-known guideline-based therapy that can provide LV synchrony through electrical resynchronization (Sami et al, 2023).…”

Section: Discussionmentioning

confidence: 99%

“…CRT is a well‐known guideline‐based therapy that can provide LV synchrony through electrical resynchronization (Sami et al, 2023 ). The first proof of concept for CRT in the CIC patient subset was provided in a retrospective analysis of 4 patients, which led to the design of the other prospective studies (Rickard et al, 2010 ).…”

Section: Discussionmentioning

confidence: 99%

Efficacy and safety of cardiac resynchronization therapy in chemotherapy‐induced cardiomyopathy: A systematic review

Shehram,

Khalid,

Shafique

et al. 2023

Noninvasive Electrocardiol

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“… 38 In addition, optimization of CRT is associated with improved clinical and echocardiographic outcomes when using intracardiac electrocardiograms, which are less time-consuming, as compared to echocardiography-based methods. 39 …”

Section: Discussionmentioning

confidence: 99%

Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis

Fyenbo,

Bjerre,

Frausing

et al. 2023

Europace

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Aims Several studies have evaluated the use of electrically- or imaging-guided left ventricular (LV) lead placement in cardiac resynchronization therapy (CRT) recipients. We aimed to assess evidence for a guided strategy that targets LV lead position to the site of latest LV activation. Methods and results A systematic review and meta-analysis was performed for randomized controlled trials (RCTs) until March 2023 that evaluated electrically- or imaging-guided LV lead positioning on clinical and echocardiographic outcomes. The primary endpoint was a composite of all-cause mortality and heart failure hospitalization, and secondary endpoints were quality of life, 6-min walk test (6MWT), QRS duration, LV end-systolic volume, and LV ejection fraction. We included eight RCTs that comprised 1323 patients. Six RCTs compared guided strategy (n = 638) to routine (n = 468), and two RCTs compared different guiding strategies head-to-head: electrically- (n = 111) vs. imaging-guided (n = 106). Compared to routine, a guided strategy did not significantly reduce the risk of the primary endpoint after 12–24 (RR 0.83, 95% CI 0.52–1.33) months. A guided strategy was associated with slight improvement in 6MWT distance after 6 months of follow-up of absolute 18 (95% CI 6–30) m between groups, but not in remaining secondary endpoints. None of the secondary endpoints differed between the guided strategies. Conclusion In this study, a CRT implantation strategy that targets the latest LV activation did not improve survival or reduce heart failure hospitalizations.

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“…Optimizing ventricular synchrony is a key goal of LBBAP. Ensuring adequate programming and optimization of pacing parameters can help restore physiological activation patterns and minimize the risk of dyssynchrony 30 . This may include adjusting the pacing site, lead position, and timing intervals to achieve optimal hemodynamics.…”

Section: Main Textmentioning

confidence: 99%

“…Ensuring adequate programming and optimization of pacing parameters can help restore physiological activation patterns and minimize the risk of dyssynchrony. 30 This may include adjusting the pacing site, lead position, and timing intervals to achieve optimal hemodynamics. By restoring ventricular synchrony, the risk of abnormal coronary blood flow dynamics and subsequent acute coronary events can be reduced.…”

Section: Optimization Of Hemodynamics and Ventricular Synchronymentioning

confidence: 99%

Coronary artery complications with left bundle branch area pacing: A review of literature

Raza,

Maqbool,

Kumar

et al. 2023

Pacing Clinical Electrophis

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Left bundle branch area pacing (LBBAP) is an emerging technique in cardiac resynchronization therapy that shows promise in improving ventricular synchrony and clinical outcomes in patients with heart failure. However, the potential risk of coronary artery complications with LBBAP necessitates careful attention and management. This literature review explores the mechanisms, acute coronary events, and clinical implications associated with coronary artery complications in LBBAP. The mechanism of coronary injury with LBBAP involves mechanical trauma, altered coronary blood flow dynamics, and endothelial damage. Acute coronary events such as myocardial ischemia, acute coronary syndromes, and coronary artery dissection can occur during or after LBBAP, leading to significant clinical implications including the need for prompt intervention and potential impact on long‐term outcomes. To avoid coronary injury and acute coronary syndrome with LBBAP, specific care strategies are recommended. These include thorough pre‐procedural evaluation, expert operator technique, optimization of hemodynamics and ventricular synchrony, close monitoring for ischemic events, collaboration with cardiology specialists, and long‐term follow‐up. The clinical implications of coronary artery complications with LBBAP necessitate careful patient selection, informed decision‐making, and a multidisciplinary approach. Future directions in this field include advancements in procedural techniques, technological innovations, risk stratification strategies, enhanced imaging modalities, research on mechanisms and prevention, and collaboration among stakeholders. By implementing these strategies and focusing on future advancements, healthcare providers can minimize the risk of coronary artery complications with LBBAP and optimize patient outcomes in cardiac resynchronization therapy.

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Echocardiography‐ versus intracardiac electrocardiogram‐based optimization of cardiac resynchronization therapy: A systematic review

Abstract: This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

Cited by 4 publications

References 52 publications

Efficacy and safety of cardiac resynchronization therapy in chemotherapy‐induced cardiomyopathy: A systematic review

Efficacy and safety of cardiac resynchronization therapy in chemotherapy‐induced cardiomyopathy: A systematic review

Targeted left ventricular lead positioning to the site of latest activation in cardiac resynchronization therapy: a systematic review and meta-analysis

Coronary artery complications with left bundle branch area pacing: A review of literature

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