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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

Effects of cardiac resynchronisation therapy on dilated cardiomyopathy with isolated ventricular non-compaction

Matteo Bertini1, Matteo Ziacchi, Mauro Biffi

  • 1Department of Cardiology, University of Bologna, Bologna, Italy.

Heart (British Cardiac Society)
|December 18, 2010
PubMed

Insights

Patients with dilated cardiomyopathy and isolated ventricular non-compaction (IVNC-DCM) showed greater left ventricular reverse remodeling after cardiac resynchronisation therapy (CRT) compared to those with DCM alone. Higher IVNC extent predicted better CRT response.

Area of Science:

  • Cardiology
  • Cardiovascular Imaging
  • Heart Failure Management

Background:

  • Dilated cardiomyopathy (DCM) is a common cause of heart failure.
  • Isolated ventricular non-compaction (IVNC) is a rare congenital cardiomyopathy.
  • Cardiac resynchronisation therapy (CRT) improves outcomes in select heart failure patients.

Purpose of the Study:

  • To compare left ventricular (LV) reverse remodeling effects of CRT in patients with DCM associated with IVNC versus DCM without IVNC.
  • To identify predictors of CRT response in IVNC-DCM patients.

Main Methods:

  • Echocardiography (standard and contrast) assessed LV volumes and function at baseline and 6 months post-CRT.
  • Patients were classified as CRT responders or non-responders based on LV reverse remodeling.
  • Comparison between 20 IVNC-DCM patients and 32 DCM patients matched for key characteristics.

Main Results:

  • IVNC-DCM patients exhibited significantly higher rates of super-response to CRT (60% vs. 28%, p=0.023).
  • A trend towards reduction in IVNC segments was observed at 6 months (p=0.067).
  • Higher baseline IVNC extent (>4 segments) predicted better CRT response (responders or super-responders, p=0.003).

Conclusions:

  • Patients with IVNC-DCM experience superior LV reverse remodeling following CRT compared to DCM patients.
  • The extent of non-compaction is a significant predictor of CRT efficacy and LV reverse remodeling in these patients.
Abstract

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