Meta-Analysis of Effects of Optimization of Cardiac Resynchronization Therapy on Left Ventricular Function, Exercise Capacity, and Quality of Life in Patients With Heart Failure

Kosmala, Wojciech; Marwick, Thomas H.

doi:10.1016/j.amjcard.2013.12.006

Cited by 37 publications

(20 citation statements)

References 30 publications

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“…Rola prób optymalizacji opóźnień AV oraz VV po implantacji urządzenia, przy użyciu metod elektrokardiograficznych, echokardiograficznych lub hemodynamicznych nie jest jasna, można je jednak rozważyć u osób, u których nie doszło do zadowalającej odpowiedzi na CRT [296,297].…”

Section: Terapia Resynchronizująca Sercaunclassified

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Ponikowski

Voors

Anker³

et al. 2016

Kardiol Pol

460

446

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Section: Terapia Resynchronizująca Sercaunclassified

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Ponikowski

Voors

Anker³

et al. 2016

Kardiol Pol

460

446

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“…Optimal ventriculo-ventricular delay may vary over time and repeated CRT optimization would contribute to maintaining the narrowest QRS duration. However, the relationship between CRT optimization and long term prognosis is inconsistent in previously published reports 14)15)16). In our study, although evaluating the accurate effect of CRT optimization on the late response was difficult because of the retrospective design, we generally performed ECG-based optimization in a routine manner in patients showing suboptimal responses.…”

Section: Discussionmentioning

confidence: 94%

Echocardiographic, Electrocardiographic Changes and Clinical Outcomes of Patients Who Respond to Cardiac Resynchronization Therapy after One Year

Choi

Jung

et al. 2017

J Cardiovasc Ultrasound

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BackgroundResponse to cardiac resynchronization therapy (CRT) is commonly assessed after 6 or 12 months. We evaluated subsequent echocardiographic changes, serial QRS duration, and clinical outcomes in patients showing delayed responses to CRT after 12 months.MethodsAmong all patients who received CRT in Seoul St. Mary's Hospital, 36 one-year survivors were enrolled. Indicators of a positive CRT response were ≥ 15% reduction in left ventricular end-systolic volume (LVESV) or ≥ 10% increase in left ventricular ejection fraction (LVEF) on any follow up echocardiogram. We defined the early responders as patients responding before one year, the late responders as patients responding after one year, and the non-responders as patients who did not respond on any follow-up echocardiogram.ResultsWe identified 17 early responders, 10 late responders, and 9 non-responders. The late responders showed modest improvement in LVESV and LVEF at two years after CRT. QRS duration was shortened the day after CRT in all three groups. Narrowed QRS was maintained for two years in early and late responders, whereas it was continuously prolonged over time in non-responders. Incidence of all-cause death or heart failure hospitalization was comparable between early and late responders, while non-responders showed worst prognosis.ConclusionPatients responding to CRT after one year show modest echocardiographic improvement but clinical outcome is similar to early responders. Shorter baseline QRS duration and long-term maintenance of QRS duration shortening are important features of the late responders to CRT.

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“…In HF patients, increased baseline LA volume (LA volume index (LAVI) >34 ml/m 2 ) has been considered a poor prognostic factor with reverse remodeling of LA occurring independent of LV remodeling [21]. Improvement in NHYA class symptoms, exercise capacity, quality of life (QOL), LV ejection fraction (at least 5 % increase from baseline), functional mitral regurgitation, pulmonary artery pressures, and lung function tests are the beneficial functional outcomes [22]. This has been validated in several observational and randomized controlled trials.…”

Section: Clinical Benefits/outcomes Of Crtmentioning

confidence: 99%

Recent Advances in the Optimization of Cardiac Resynchronization Therapy

Chandraprakasam

Mentzer

2014

Curr Heart Fail Rep

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Heart failure (HF) continues to grow and affect more than five million people in the USA. One of the leading device therapies in HF is cardiac resynchronization therapy (CRT) which has been studied for over 20 years. Recent advancements in lead placement, lead technology, patient selection, and CRT optimization by electrical maneuvers and imaging modalities have improved outcomes in morbidity, hospitalization reductions and mortalities in those who have responded CRT therapy. This review article is intended to discuss the mechanisms and benefits of CRT, clinical trials, and guidelines for CRT along with a focus on recent updates from the past 3 to 5 years and glimpse into future directions.

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Meta-Analysis of Effects of Optimization of Cardiac Resynchronization Therapy on Left Ventricular Function, Exercise Capacity, and Quality of Life in Patients With Heart Failure

Cited by 37 publications

References 30 publications

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure

Echocardiographic, Electrocardiographic Changes and Clinical Outcomes of Patients Who Respond to Cardiac Resynchronization Therapy after One Year

Recent Advances in the Optimization of Cardiac Resynchronization Therapy

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