Changes in cardiac conduction time following cardiac resynchronization therapy: rationale and design of the RECOVER
Hye Bin Gwag1, June Soo Kim2, Kyoung-Min Park2
1Division of Cardiology, Department of Internal Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea.
Insights
Serial changes in ventricular conduction times may predict cardiac resynchronization therapy (CRT) response in heart failure (HF) patients. This study tracks these changes over two years to assess their prognostic value.
Area of Science:
- Cardiology
- Electrophysiology
- Heart Failure Research
Background:
- Ventricular conduction delays are critical for cardiac resynchronization therapy (CRT) success in advanced heart failure (HF).
- Previous research has not examined serial changes in conduction times between CRT device electrodes.
Purpose of the Study:
- To investigate serial changes in interelectrode conduction times in CRT patients.
- To determine the prognostic value of these conduction time changes.
- To correlate conduction time alterations with CRT response defined by echocardiography.
Main Methods:
- The Reduction or Extension of Conduction Time with Ventricular Electromechanical Remodeling (RECOVER) study will enroll 100 patients with CRT systems.
- Interelectrode conduction times will be measured every 3 months over a 2-year follow-up period.
- The primary outcome is the correlation between conduction time changes and CRT response.
Main Results:
- Data collection and analysis are ongoing.
- The study aims to identify patterns in conduction time changes over time.
- The prognostic significance of these serial changes is under investigation.
Conclusions:
- The RECOVER study explores the utility of serial interelectrode conduction time changes.
- These parameters may help predict CRT response.
- Early detection of worsening heart failure may also be possible.
Background:
It has been known that ventricular conduction delays play a key role in the cardiac resynchronization therapy (CRT) response of patients with advanced heart failure (HF). However, no study to our knowledge has yet evaluated the serial changes in conduction times measured between different electrodes of CRT devices.
Methods And Results:
The Reduction or Extension of Conduction Time with Ventricular Electromechanical Remodeling (RECOVER) study (NCT04397224) was designed to investigate serial changes in interelectrode conduction times and to elucidate their prognostic value. We plan to enroll 100 patients implanted with CRT systems with endocardial quadripolar left ventricular leads. Patients will be scheduled for follow-up every 3 months over a period of 2 years, where they will undergo measurement of interelectrode conduction times to evaluate their serial changes. The primary outcome of the RECOVER study is the correlation between the degree of conduction time changes and the CRT response as defined by echocardiography. The time course and prognostic value of the serial changes in conduction times will be investigated as well.
Conclusion:
The RECOVER study is investigating whether serial changes in interelectrode conduction times can be useful parameters in predicting the CRT response or detecting worsening HF at an early stage.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Cardiac Action Potential
The cardiac action potential process involves a series of phases characterized by the movement of ions across the cardiac cell membranes, leading to the depolarization and repolarization of the cardiac myocytes.
Ionic Basis of Cardiac Action Potentials
01:19Electrophysiology of Normal Cardiac Rhythm