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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

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

Measures of left ventricular dyssynchrony and the correlation to clinical and echocardiographic response after

Raed Abdelhadi1, Evan Adelstein, Andrew Voigt

  • 1Cardiovascular Institute, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania, USA.

The American Journal of Cardiology
|August 30, 2008
PubMed

Insights

Cardiac resynchronization therapy (CRT) significantly reduces left ventricular (LV) dyssynchrony. Improvement in longitudinal LV dyssynchrony after CRT correlates with better quality of life, though acute changes don't predict long-term echocardiographic outcomes.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Heart Failure Management

Background:

  • Standardized measures for left ventricular (LV) dyssynchrony and cardiac resynchronization therapy (CRT) response are lacking.
  • Echocardiography is crucial for assessing LV dyssynchrony in CRT candidates.

Purpose of the Study:

  • To evaluate the immediate and intermediate-term effects of CRT on LV dyssynchrony.
  • To determine the correlation between changes in LV dyssynchrony and clinical/echocardiographic outcomes post-CRT.
  • To assess the concordance between clinical and echocardiographic response to CRT.

Main Methods:

  • Echocardiographic assessment of LV dyssynchrony (radial and longitudinal) before and immediately after CRT device implantation.
  • Follow-up of 44 patients for 6 months post-implantation.
  • Correlation analysis between LV dyssynchrony measures and quality of life (QoL), New York Heart Association (NYHA) classification, and echocardiographic outcomes.

Main Results:

  • Significant immediate reduction in both radial and longitudinal LV dyssynchrony post-CRT (p <0.001 and p = 0.02, respectively).
  • Immediate change in radial LV dyssynchrony correlated with improved physical QoL at 6 months (r = -0.43, p = 0.015).
  • Higher baseline LV dyssynchrony predicted improved NYHA classification, but acute changes did not predict echocardiographic outcomes.

Conclusions:

  • CRT effectively reduces both radial and longitudinal LV dyssynchrony.
  • Improved longitudinal LV dyssynchrony post-CRT correlates with enhanced physical quality of life in the intermediate term.
  • Clinical and echocardiographic responses to CRT showed concordance in 72% of patients.

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