Optimizing cardiac resynchronization therapy

被引：0
作者：
Hasan A. [1 ]
机构：
[1] Division of Cardiovascular Medicine, Ohio State University Heart Center, Columbus, OH 43210
来源：
Current Heart Failure Reports | 2008年 / 5卷 / 1期
关键词：
Right Ventricular; Cardiac Resynchronization Therapy; Mechanical Dyssynchrony; Biventricular Pace; Right Ventricular Pace;
D O I：
10.1007/s11897-008-0007-z
中图分类号：
学科分类号：
摘要：
Cardiac resynchronization therapy (CRT) improves clinical outcome and survival in advanced heart failure. However, some patients do not respond clinically or show improvement in left ventricular function. Our focus has turned to why such "nonresponders" exist. Follow-up of CRT has led to several explanations, varying by individual patient, and has shown the importance of device programming in CRT in heart failure. The failing heart displays delayed contraction in the ventricle, also referred to as mechanical dyssynchrony. Simply pacing both ventricles simultaneously might not be adequate to optimize systolic function. Individually tailoring the atrioventricular (AV) timing can improve left ventricular filling and cardiac output, and adjusting the interventricular (VV) pacing delay has also been shown to improve hemodynamics. Increasing evidence regarding AV and VV optimization is emerging. This article reviews the current data on optimization, including the physiology, numerous approaches, and current issues. © Springer Science+Business Media, LLC 2008.
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页码：38 / 43
页数：5
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  • [1] Cazeau S., Leclercq C., Lavergne T., Et al., Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay, N Engl J Med, 344, pp. 873-880, (2001)
  • [2] Abraham W.T., Fisher W.G., Smith A.L., Et al., Cardiac resynchronization in chronic heart failure, N Engl J Med, 346, pp. 1845-1853, (2002)
  • [3] Linde C., Leclercq C., Rex S., Et al., Long-term benefits of biventricular pacing in congestive heart failure: Results from the Multisite Stimulation in Cardiomyopathy (MUSTIC) study, J Am Coll Cardiol, 40, pp. 111-118, (2002)
  • [4] Cleland J.G., Daubert J.C., Erdmann E., Et al., The effect of cardiac resynchronization on morbidity and mortality in heart failure, N Engl J Med, 352, pp. 1539-1549, (2005)
  • [5] Yu C.M., Fung J.W., Zhang Q., Et al., Tissue Doppler imaging is superior to strain rate imaging and postsystolic shortening on the prediction of reverse remodeling in both ischemic and nonischemic heart failure after cardiac resynchronization therapy, Circulation, 110, pp. 66-73, (2004)
  • [6] Bader H., Garrigue S., Lafitte S., Et al., Intra-left ventricular electromechanical asynchrony. A new independent predictor of severe cardiac events in heart failure patients, J Am Coll Cardiol, 43, pp. 248-256, (2004)
  • [7] Butter C., Auricchio A., Stellbrink C., Et al., Effect of resynchronization therapy stimulation site on the systolic function of heart failure patients, Circulation, 104, pp. 3026-3029, (2001)
  • [8] Wang P., Kramer A., Estes III N.A., Et al., Timing cycles for biventricular pacing, Pacing Clin Electrophysiol, 25, pp. 62-75, (2002)
  • [9] Auricchio A., Stellbrink C., Block M., Et al., Effect of pacing chamber and atrioventricular delay on acute systolic function of paced patients with congestive heart failure. The Pacing Therapies for Congestive Heart Failure Study Group. The Guidant Congestive Heart Failure Research Group, Circulation, 99, pp. 2993-3001, (1999)
  • [10] Jansen A.H., Bracke F.A., van Dantzig J.M., Et al., Correlation of echo-Doppler optimization of atrioventricular delay in cardiac resynchronization therapy with invasive hemodynamics in patients with heart failure secondary to ischemic or idiopathic dilated cardiomyopathy, Am J Cardiol, 97, pp. 552-557, (2006)
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