Enhancing Response in the Cardiac Resynchronization Therapy Patient: The 3B Perspective-Bench, Bits, and Bedside

JACC. Clinical Electrophysiology
Angelo Auricchio, Frits W Prinzen

Abstract

Cardiac resynchronization therapy (CRT) is an established nonpharmacological treatment for patients with heart failure (HF), reduced left ventricular (LV) ejection fraction, and a wide QRS complex. Although the therapy was developed 30 years ago and approved by the Food and Drug Administration in 2001, attempts to improve it have never stopped. Such improvements have been facilitated by combining knowledge from bench (basic science), bits (computer modeling), and bedside (clinical studies); these issues are addressed in the present review. Improvements include better patient selection, positioning of the LV lead, pacing from multiple sites, and optimization of atrioventricular and ventriculo-ventricular intervals. Overall, patterns of electrocardiographic and echocardiographic (strain) signals appear to be more useful for patient selection than timing intervals (QRS duration, time-to-peak shortening). Quadripolar leads have significantly improved CRT outcome due to increased electrical and mechanical lead performance (avoiding phrenic nerve stimulation and improving lead stability), but also thanks to the flexibility offered by the novel leads to avoid in-scar pacing. The benefit of multiple site stimulation over optimal conven...Continue Reading

References

Jun 27, 2002·Journal of the American College of Cardiology·Angelo AuricchioUNKNOWN Pacing Therapies in Congestive Heart Failure (PATH-CHF) Study Group
Feb 5, 2008·International Journal of Cardiology·Radosław LenarczykZbigniew Kalarus
Apr 12, 2008·Journal of the American College of Cardiology·Christophe LeclercqUNKNOWN TRIP-HF (Triple Resynchronization In Paced Heart Failure Patients) Study Group
Jan 29, 2009·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·David R TomlinsonKim Rajappan
Sep 1, 2009·Annals of Biomedical Engineering·Joost LumensTheo Arts
Sep 3, 2009·The New England Journal of Medicine·Arthur J MossUNKNOWN MADIT-CRT Trial Investigators
Oct 22, 2009·Circulation. Arrhythmia and Electrophysiology·Caroline van DeursenFrits W Prinzen
Aug 28, 2010·Journal of the American College of Cardiology·David D SpraggRonald D Berger
Nov 16, 2010·The New England Journal of Medicine·Anthony S L TangUNKNOWN Resynchronization-Defibrillation for Ambulatory Heart Failure Trial Investigators
Mar 8, 2011·The American Journal of Cardiology·David G StraussGalen S Wagner
Jun 15, 2011·Journal of Cardiovascular Magnetic Resonance : Official Journal of the Society for Cardiovascular Magnetic Resonance·Francisco LeyvaAngelo Auricchio
Nov 2, 2011·Pacing and Clinical Electrophysiology : PACE·Steven A NiedererC A Rinaldi
Dec 2, 2011·Journal of Cardiovascular Translational Research·Marc StrikKevin Vernooy
Feb 9, 2012·European Journal of Heart Failure·Dominic P S RogersAnthony W C Chow
Jul 17, 2012·Heart Rhythm : the Official Journal of the Heart Rhythm Society·David O MartinUNKNOWN Adaptive CRT Study Investigators
Apr 13, 2013·JACC. Cardiovascular Imaging·Valentina KutyifaWojciech Zareba
Apr 26, 2013·Circulation. Heart Failure·Paul A HeidenreichUNKNOWN Stroke Council
May 4, 2013·European Heart Journal·Cecilia LindeUNKNOWN REsynchronization reVErses Remodeling in Systolic left vEntricular dysfunction Study Group
May 23, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Michio OganoKyoichi Mizuno
Sep 4, 2013·The New England Journal of Medicine·Frank RuschitzkaUNKNOWN EchoCRT Study Group
Sep 10, 2013·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Jagmeet P SinghDavid O Martin
Dec 3, 2013·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Carlo PapponeVincenzo Santinelli
Feb 6, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Angelo AuricchioUNKNOWN Collaborative Study Group
Feb 15, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Anoop K ShettyC Aldo Rinaldi
May 21, 2014·Nature Reviews. Cardiology·Kevin VernooyFrits W Prinzen
Jul 18, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Zoltan BakosRasmus Borgquist
Sep 18, 2014·Journal of Cardiovascular Electrophysiology·Elien B EngelsFrits W Prinzen
Nov 2, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Mark PotseAngelo Auricchio
Nov 6, 2014·Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology·Giovanni B ForleoFrancesco Romeo
Dec 3, 2014·Journal of Electrocardiology·Caroline J M van DeursenLiliane Wecke
Jan 28, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Francesco ZanonFrits W Prinzen
Feb 14, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Carlo PapponeVincenzo Santinelli
Mar 10, 2015·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Wilco KroonAngelo Auricchio

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Citations

Jul 20, 2018·Current Cardiology Reports·Scott Anjewierden, Peter F Aziz
Sep 14, 2018·Herz·J Müller-LeisseC Veltmann
May 30, 2019·Frontiers in Cardiovascular Medicine·Matteo Dal FerroGianni Pedrizzetti
Oct 27, 2018·Nature Reviews. Cardiology·Steven A NiedererNatalia A Trayanova
Oct 12, 2020·European Heart Journal Cardiovascular Imaging·Erwan DonalElena Galli
Jan 11, 2021·Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography·Elena GalliErwan Donal
Oct 17, 2020·Heart Rhythm : the Official Journal of the Heart Rhythm Society·Pamela K MasonJagmeet P Singh

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