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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,...
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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...
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Dysrhythmia management involves a multifaceted approach, incorporating pharmacological treatments, medical procedures, surgical interventions, lifestyle modifications, and patient education.Pharmacological ManagementAntiarrhythmic Drugs:Class I (Sodium Channel Blockers): This class includes quinidine and procainamide, which reduce the speed of impulse conduction in the heart, stabilize the cardiac membrane, and control arrhythmias. Quinidine and procainamide are Class IA agents that prolong the...
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Pharmacologic intervention is crucial in treating cardiac arrest patients during ACLS or Advanced Cardiovascular Life Support. The ACLS algorithms guide the administration of specific drugs based on the patient's cardiac arrest rhythm, which includes pulseless ventricular tachycardia (VT), ventricular fibrillation (VF), asystole, and pulseless electrical activity (PEA).EpinephrineIndication: Epinephrine is the first-line drug for all cardiac arrest rhythms.Mechanism of Action: Epinephrine...
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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.
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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...
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Multicenter prospective observational study to clarify the current status and clinical outcome in Japanese patients who have an indication for implantable cardioverter defibrillator (ICD) or wearable cardioverter defibrillator (WCD) (TRANSITION JAPAN-ICD/WCD study): Rationale and design of a prospective, multicenter, observational, comparative study.

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Related Experiment Video

Updated: Oct 12, 2025

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Cardiac resynchronization therapy: Current status and near-future prospects.

Toshiko Nakai1, Yukitoshi Ikeya2, Rikitake Kogawa2

  • 1Nihon University School of Medicine, Department of Medicine, Division of Advanced Therapeutics for Cardiac Arrhythmias, Tokyo, Japan.

Journal of Cardiology
|November 20, 2021
PubMed
Summary

Cardiac resynchronization therapy (CRT) improves heart failure by correcting conduction disorders, not curing the disease. Rethinking CRT response is key to increasing its proper utilization in heart failure patients.

Keywords:
DyssynchronyPacing therapyVentricular conduction disturbance

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Area of Science:

  • Cardiology
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) is a standard heart failure treatment with proven effectiveness.
  • Underutilization of CRT remains a significant clinical challenge, partly due to CRT non-responders.
  • CRT non-response has been a recognized issue for approximately 20 years, with reported rates around 30%.

Purpose of the Study:

  • To analyze the current state of CRT and identify factors contributing to its underutilization.
  • To re-evaluate the concept of CRT response in the context of heart failure's progressive nature.
  • To advocate for a paradigm shift in understanding CRT's role and benefits.

Main Methods:

  • Review of existing clinical trial data and clinical practice observations regarding CRT effectiveness and response.
  • Analysis of the pathophysiology of heart failure and the mechanism of CRT action.
  • Conceptual re-evaluation of CRT response criteria and its implications.

Main Results:

  • Heart failure is a progressive disease, and CRT, like medications, manages rather than cures it.
  • CRT's primary role is to correct conduction disorders and dyssynchrony, thereby mitigating heart failure exacerbating factors.
  • Pacing is the sole treatment for conduction disorders, positioning CRT as essential for heart failure with conduction abnormalities.

Conclusions:

  • Misunderstandings regarding CRT response determination may contribute to underutilization.
  • A revised understanding of CRT's mechanism—modifying, not curing—is crucial.
  • Proper utilization of CRT can be enhanced by returning to its origins and adopting a new perspective on response.