Related Experiment Video
Updated: Jul 7, 2026
Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
Published on: December 11, 2017
[Long term results of cardiac resynchronisation therapy for patients with severe heart failure]
1I. interní klinika Lékarské fakulty UP a FN Olomouc. alanbulava@seznam.cz
Insights
Cardiac resynchronisation therapy (CRT) is effective for severe chronic heart failure (ChHF). Less advanced heart disease and interventricular delay predict positive treatment response, aiding in identifying suitable candidates.
Area of Science:
- Cardiology
- Heart Failure Management
- Medical Device Therapy
Context:
- Severe chronic heart failure (ChHF) significantly impacts patient morbidity and mortality.
- Cardiac resynchronisation therapy (CRT) is an established treatment for eligible ChHF patients.
- Identifying optimal candidates for CRT remains a clinical challenge.
Purpose:
- To evaluate the clinical response, morbidity, and mortality in ChHF patients undergoing CRT.
- To identify predictors of mortality and CRT response.
- To assess the utility of tissue Doppler echocardiography parameters in predicting CRT response.
Summary:
- A study of 102 ChHF patients (NYHA III/IV) receiving CRT showed a 64% clinical response rate at 12 months.
- Significant improvements in left ventricular ejection fraction (EF LV) were observed in 58% of patients.
- Predictors of positive response included less advanced disease (EF LV > 23%, smaller ventricular dimensions) and interventricular mechanical delay > 45 ms.
Impact:
- CRT is a safe and effective treatment for severe ChHF, improving patient outcomes.
- Early identification of responders through clinical and echocardiographic parameters can optimize therapy.
- Further research into predictive markers can enhance patient selection and treatment efficacy.
Introduction:
Cardiac resynchronisation therapy (CRT) has been shown to be a highly effective treatment strategy for patients with severe chronic heart failure (ChHF).
Objective Of Study:
To determine the clinical response of patients to CRT, to measure morbidity and mortality for this population of patients, to determine causes and predictors of death. To test whether the parameters of tissue Doppler echocardiography are able to predict response to CRT.
Patients And Methods:
Before and after implantation of the CRT and 12 months later, echocardiograph tests were carried out and relevant clinical data was recorded during the monitoring of patients.
Results:
102 patients (71 men, 31 women) with an average age of 71 +/- 9 years took part in the study. 68% patients had cardiac ischemia, 29% had idiopathic dilated cardiomyopathy. 75% patients were in functional class NYHA III, 25% NYHA IV. After a monitoring period of 711 +/- 329 days, 26 patients had died and 35 patients had been hospitalised. 34% of all hospitalisations were for acute exacerbation of ChHF. Patients with initial functional classification NYHA IV had a higher mortality rate in years one and two than patients in class NYHA III. The proportion of clinical responders was 64% after 12 months of CRT. In 58% of patients, a year of CRT produced a relative increase in the ejection fraction of the left ventricle (EF LV) of > or = 30%. 1/3 of patients had EF LV ? 45% with minimal symptoms of ChHF. The following were found to predict reverse remodelling of the left ventricle: less advanced state of the basic illness (EFLV > 23%, left ventricular end-diastolic diameter < 65 mm, left ventricular end-diastolic volume < 160 ml and left ventricular end-systolic volume < 120 ml) and interventricular mechanical delay > 45 ms.
Conclusion:
CRT is a safe method with a high success rate. There continues to be a problem with identifying responders. Symptoms of less advanced heart disease and interventricular delay were identified as sensitive predictors of the response to treatment.
Related Concept Videos
01:22Heart Failure VI: Adjunct Therapies
01:30Cardiomyopathy II: Dilated Cardiomyopathy
01:29Cardiomyopathy V: Interprofessional Care
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:30Heart Failure V: Medical Management