An Overview of Current Cardiac Resynchronization Therapy
Chien-Ming Cheng1, Jin-Long Huang2, Tsu-Juey Wu3
1Division of Cardiology, Department of Medicine, Fong Yuan Hospital of Ministry of Health and Welfare; ; Institute of Clinical Medicine, and Cardiovascular Research Institute, National Yang-Ming University, Taipei;
Acta Cardiologica Sinica
|April 29, 2016
Summary
Cardiac resynchronization therapy (CRT) improves heart failure (HF) outcomes. This review covers updated guidelines, new indications, and advanced techniques like left ventricular lead placement and device optimization for CRT.
Area of Science:
- Cardiology
- Medical Devices
- Heart Failure Management
Background:
- Cardiac resynchronization therapy (CRT) is an established treatment for heart failure (HF).
- Recent advancements in implantation techniques, device technology, and clinical trials have refined CRT.
- Key areas include updated guidelines, expanded indications, and optimization strategies.
Purpose of the Study:
- To review updated guidelines and emerging indications for CRT.
- To highlight novel approaches in left ventricular (LV) lead placement and multi-site LV pacing.
- To discuss the role of automatic device optimization in enhancing CRT efficacy.
Main Methods:
- Literature review of recent clinical trials and guideline updates.
- Analysis of new techniques for LV lead implantation.
- Evaluation of automatic device optimization algorithms.
Main Results:
- Updated guidelines may expand CRT indications to patients with mild HF symptoms and prolonged QRS duration.
- Novel LV lead placement strategies and multi-site LV pacing show promise.
- Automatic device optimization can improve CRT effectiveness.
Conclusions:
- CRT remains a vital therapy for heart failure, with evolving indications and techniques.
- Further research into new patient populations and optimization methods is warranted.
- Optimized CRT delivery is crucial for maximizing patient benefit.
Related Concept Videos
01:30Pulse rhythm
1.6K
Pulse rhythm refers to the pattern of pulsations within specific intervals, offering valuable insights into the regularity or irregularity of the heart's beats as observed through the pattern of pulsation within specific intervals. A regular pulse exhibits a consistent heart rate with uniform waveforms and pulsation force, variations of which can be classified as normal, weak, or bounding.
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
Conversely, an irregular pulse pattern is termed dysrhythmia, stemming from disruptions in cardiac...
1.6K
01:29Cardiomyopathy IV: Restrictive Cardiomyopathy
755
Restrictive cardiomyopathy (RCM) is a rare heart muscle disease characterized by impaired ventricular filling due to stiffened ventricular walls, leading to significant diastolic dysfunction.EtiologyRestrictive cardiomyopathy can arise from both inherited and acquired diseases, many of which are systemic. It is categorized into four main types: infiltrative, storage, non-infiltrative, and endomyocardial diseases.Infiltrative diseases, such as amyloidosis, lead to RCM by depositing amyloid...
755
01:29Cardiomyopathy V: Interprofessional Care
605
Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
605
01:22Heart Failure VI: Adjunct Therapies
531
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.
531
01:30Cardiomyopathy II: Dilated Cardiomyopathy
733
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,...
733
01:29Cardiomyopathy III: Hypertrophic Cardiomyopathy
643
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...
643