Clinical and electrocardiographic predictors of a positive response to cardiac resynchronization therapy in advanced
Guillaume Lecoq1, Christophe Leclercq, Emmanuelle Leray
1Department of Cardiology, Centre Hospitalier Universitaire, Rennes F-35000, France.
European Heart Journal
|February 25, 2005
Summary
The amount of QRS shortening (DeltaQRS) during biventricular stimulation is the sole predictor of positive response to cardiac resynchronization therapy (CRT). This finding helps identify patients likely to benefit from CRT for heart failure.
Area of Science:
- Cardiology
- Heart Failure Management
- Medical Devices
Background:
- Cardiac resynchronization therapy (CRT) is a treatment for heart failure.
- Up to 30% of patients do not respond to CRT.
- Predicting CRT response is crucial for patient selection.
Purpose of the Study:
- To identify clinical and electrocardiographic (ECG) predictors of positive response to CRT.
- To improve patient selection for CRT.
Main Methods:
- Retrospective study of 139 patients receiving CRT.
- Analysis of demographic, clinical, and ECG variables.
- Logistic regression to identify predictors of CRT response.
Main Results:
- 73% of patients responded to CRT at 6 months.
- The amount of QRS shortening (DeltaQRS) was the only independent predictor of CRT response.
- Positive responders showed significantly greater DeltaQRS (37 ms) compared to non-responders (11 ms).
Conclusions:
- DeltaQRS is a strong predictor of CRT response.
- This metric can aid in selecting patients for CRT.
- Further research may refine CRT response prediction.
More Related Videos
Related Concept Videos
01:26Heart Failure III: Clinical Manifestations
1.2K
Heart failure (HF) manifests primarily as dyspnea, fatigue, and fluid retention, resulting in peripheral and pulmonary edema. Symptoms may vary depending on which ventricle is more affected, left or right.Left-Sided Heart FailureAlso known as left ventricular failure, this condition results from the left ventricle's inability to fill or eject sufficient blood into the systemic circulation. It leads to pulmonary congestion, which occurs when the left ventricle fails to eject blood effectively...
1.2K
01:30Heart Failure IV: Classification and Diagnostic Evaluation
1.0K
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
1.0K
01:30Heart Failure V: Medical Management
626
Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
626
01:22Heart Failure VI: Adjunct Therapies
632
Additional therapies for treating patients with heart failure (HF) may include procedural interventions, supplemental oxygen, the management of sleep disorders, and nutritional therapy.Procedural InterventionsImplantable Cardioverter-Defibrillator: For patients at risk of life-threatening arrhythmias due to severe left ventricular dysfunction, an Implantable Cardioverter-Defibrillator (ICD) can detect and terminate these arrhythmias, preventing sudden cardiac death and improving survival rates.
632
01:30Cardiomyopathy II: Dilated Cardiomyopathy
790
Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
790
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
805
Hypertrophic cardiomyopathy, or HCM, is an autosomal dominant genetic disorder characterized by asymmetric left ventricular hypertrophy without ventricular dilation. It is more common in men and is typically diagnosed in young, athletic adults.EtiologyHCM is primarily genetic and is caused by mutations in genes encoding sarcomeric proteins. Researchers have identified over 1400 mutations across at least 11 different genes. Among these, the most frequently occurring mutations are found in the...
805