Regular paperComparison of benefits from cardiac resynchronization therapy in patients with ischemic cardiomyopathy versus idiopathic dilated cardiomyopathy
Section snippets
Patients and study protocol
Consecutive patients (n = 74) who received a biventricular pacemaker for congestive heart failure were included. The traditional selection criteria for CRT were applied: New York Heart Association (NYHA) class III or IV; left ventricular (LV) ejection fraction <35%; QRS duration >120 ms; and left bundle branch block morphology.1, 2, 3 Clinical evaluation was performed before pacemaker implantation and repeated after 6 months of CRT. Clinical evaluation included assessment of NYHA class,
Patient population
A total of 74 consecutive patients were included, with 40 (54%) having IDC and 34 (46%) IC. Of the patients with IC, 31 (91%) had a prior infarction (90% anterior wall, 71% with a Q wave) and the mean number of stenosed coronary arteries was 2.3 ± 1.0. The study population comprised 58 men and 16 women, with a mean age of 65 ± 11 years. According to the inclusion criteria, all patients had a wide QRS complex (177 ± 29 ms, range 120 to 220) and left bundle branch block configuration. The mean
Discussion
In line with previous observations,1, 2, 3 CRT resulted in a significant improvement in symptoms, exercise capacity (as reflected in the 6-minute walking distance), and systolic function (as expressed in LV ejection fraction). In the present study, CRT improved the 6-minute walking distance by 38% on average, comparable with the 23% shown by Cazeau et al.11 LV ejection fraction improved significantly, which is in line with previous observations by Sogaard et al,12 who showed an improvement from
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Impact on long-term cardiovascular outcomes of different cardiac resynchronization therapy response criteria
2018, Revista Portuguesa de CardiologiaRelationship between left ventricular dyssynchrony and systolic dysfunction is independent of impaired left ventricular myocardial perfusion in heart failure: Assessment with 99mTc-sestamibi gated myocardial scintigraphy
2013, International Journal of CardiologyCitation Excerpt :In contrast, a reduced LV myocardial perfusion, as assessed with myocardial 99mTc-MIBI uptake, was reported not to be a predictor for the response of CRT in patients with HF [29]. Moreover, it has been reported that the benefit of CRT does not differ significantly between patients with ischemic cardiomyopathy and those with nonischemic cardiomyopathy [30–33]. Recent evidence has suggested that the presence of myocardial scar tissues reduces the beneficial effect of CRT because the electric stimuli for CRT may be blocked by the scar tissues, in particular those seen near the tip of the LV pacing lead [34–38].
Effects of adaptive left bundle branch–optimized cardiac resynchronization therapy: a single centre experience
2022, BMC Cardiovascular Disorders