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[Cardiac resynchronization therapy for heart failure].

Augusto Achilli1, Nicolino Patruno, Daniele Pontillo

  • 1UTIC e U.O.D. di Elettrofisiologia, Ospedale Belcolle, Viterbo.

Italian Heart Journal. Supplement : Official Journal of the Italian Federation of Cardiology
|October 9, 2004
PubMed
Summary

Cardiac resynchronization therapy improves heart failure symptoms and function in many patients. However, identifying non-responders remains a challenge, with new imaging techniques showing promise.

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Effective nonapical left ventricular pacing with quadripolar leads for cardiac resynchronization therapy.

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Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Advanced refractory heart failure has a poor prognosis, linked to left ventricular dysfunction.
  • Conduction delays affect nearly 50% of heart failure patients, impacting cardiac performance.
  • Correcting electrical abnormalities offers a potential therapeutic avenue.

Purpose of the Study:

  • To evaluate the efficacy of biventricular stimulation (cardiac resynchronization therapy) in heart failure patients.
  • To identify factors influencing response to cardiac resynchronization therapy.
  • To explore methods for reducing non-responder rates in cardiac resynchronization therapy.

Main Methods:

  • Biventricular stimulation (cardiac resynchronization therapy) to correct mechanical asynchrony.
  • Analysis of clinical trial data for patients with NYHA class III-IV heart failure, specific QRS duration, LV end-diastolic diameter, and ejection fraction.

Related Experiment Videos

  • Utilizing Tissue Doppler imaging to assess left ventricular dyssynchrony in ongoing studies.

    • Main Results:

    • Biventricular pacing significantly improved left ventricular performance, quality of life, and NYHA class.
    • No significant impact on total mortality was observed in completed trials.
    • Approximately 20-30% of patients were identified as non-responders in prior studies.

    Conclusions:

    • Cardiac resynchronization therapy is a valuable treatment for selected heart failure patients, improving key functional parameters.
    • The identification and management of non-responders is a critical area for further research.
    • Tissue Doppler imaging may help personalize therapy and reduce the percentage of non-responders.