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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

Cardiac resynchronization therapy to prevent life-threatening arrhythmias in patients with congestive heart failure

Takashi Kurita1, Takashi Noda, Takeshi Aiba

  • 1Department of Medicine, Division of Cardiology, Faculty of Medicine, Kinki University, Osaka, Japan. kuritat@med.kindai.ac.jp

Journal of Electrocardiology
|October 25, 2011
PubMed

Insights

Cardiac resynchronization therapy (CRT) reduces mortality and sudden cardiac death. However, CRT can cause proarrhythmia in about 10% of patients, influencing device choice.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) is known to improve structural and electrical remodeling in heart failure patients.
  • Clinical data suggest CRT favorably impacts ventricular myocyte function, potentially through ionic and genetic modulation.

Purpose of the Study:

  • To evaluate the antiarrhythmic effects of CRT and its potential proarrhythmic risks.
  • To investigate the impact of CRT on ventricular myocyte ion channel and calcium homeostasis.

Main Methods:

  • Analysis of clinical data from studies testing CRT devices without defibrillation capabilities.
  • Review of animal experiments mimicking disorganized ventricular contraction to understand CRT's cellular mechanisms.

Main Results:

  • CRT significantly reduces total mortality, partly by preventing sudden cardiac death.
  • CRT reverses down-regulation of K+ channels and abnormal Ca2+ homeostasis in failing hearts.
  • Approximately 10% of patients experience proarrhythmic effects early after CRT initiation.

Conclusions:

  • CRT offers significant benefits in reducing mortality and improving cardiac function.
  • The proarrhythmic potential of CRT, though relatively low, warrants consideration in clinical practice.
  • The incidence of proarrhythmia may influence the selection between CRT with defibrillation (CRT-D) and pacing (CRT-P) devices.

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