Journal ArticleDOI
Effects of Multisite Biventricular Pacing in Patients with Heart Failure and Intraventricular Conduction Delay
Serge Cazeau,Christophe Leclercq,Thomas Lavergne,S Walker,Varma C,Cecilia Linde,Stéphane Garrigue,Lukas Kappenberger,G A Haywood,Massimo Santini,Bailleul C,Jean-Claude Daubert,Multisite Stimulation in Cardiomyopathies (Mustic) Study Investigators +12 more
TLDR
In this article, transvenous atriobiventricular pacemakers (with leads in one atrium and each ventricle) were used to reduce ventricular asynchrony.Abstract:
BACKGROUND: One third of patients with chronic heart failure have electrocardiographic evidence of a major intraventricular conduction delay, which may worsen left ventricular systolic dysfunction through asynchronous ventricular contraction. Uncontrolled studies suggest that multisite biventricular pacing improves hemodynamics and well-being by reducing ventricular asynchrony. We assessed the clinical efficacy and safety of this new therapy. METHODS: Sixty-seven patients with severe heart failure (New York Heart Association class III) due to chronic left ventricular systolic dysfunction, with normal sinus rhythm and a duration of the QRS interval of more than 150 msec, received transvenous atriobiventricular pacemakers (with leads in one atrium and each ventricle). This single-blind, randomized, controlled crossover study compared the responses of the patients during two periods: a three-month period of inactive pacing (ventricular inhibited pacing at a basic rate of 40 bpm) and a three-month period of active (atriobiventricular) pacing. The primary end point was the distance walked in six minutes; the secondary end points were the quality of life as measured by questionnaire, peak oxygen consumption, hospitalizations related to heart failure, the patients' treatment preference (active vs. inactive pacing), and the mortality rate. RESULTS: Nine patients were withdrawn from the study before randomization, and 10 failed to complete both study periods. Thus, 48 patients completed both phases of the study. The mean distance walked in six minutes was 22 percent greater with active pacing (399+/-100 m vs. 326+/-134 m, P<0.001), the quality-of-life score improved by 32 percent (P<0.001), peak oxygen uptake increased by 8 percent (P<0.03), hospitalizations were decreased by two thirds (P<0.05), and active pacing was preferred by 85 percent of the patients (P<0.001). CONCLUSIONS: Although it is technically complex, atriobiventricular pacing significantly improves exercise tolerance and quality of life in patients with chronic heart failure and intraventricular conduction delay.read more
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2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC.
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer,Gerasimos Filippatos,John J.V. McMurray,Victor Aboyans,Stephan Achenbach,Stefan Agewall,Nawwar Al-Attar,John Atherton,Johann Bauersachs,A. John Camm,Scipione Carerj,Claudio Ceconi,Antonio Coca,Perry M. Elliott,Çetin Erol,Justin A. Ezekowitz,Covadonga Fernández-Golfín,Donna Fitzsimons,Marco Guazzi,Maxime Guenoun,Gerd Hasenfuss,Gerhard Hindricks,Arno W. Hoes,Bernard Iung,Tiny Jaarsma,Paulus Kirchhof,Juhani Knuuti,Philippe Kolh,Stavros Konstantinides,Mitja Lainscak,Patrizio Lancellotti,Gregory Y.H. Lip,Francesco Maisano,Christian Mueller,Mark C. Petrie,Massimo F Piepoli,Silvia G. Priori,Adam Torbicki,Hiroyuki Tsutsui,Dirk J. van Veldhuisen,Stephan Windecker,Clyde W. Yancy,José Luis Zamorano +62 more
TL;DR: Authors/Task Force Members: Piotr Ponikowski* (Chairperson) (Poland), Adriaan A. Voors* (Co-Chair person) (The Netherlands), Stefan D. Anker (Germany), Héctor Bueno (Spain), John G. F. Cleland (UK), Andrew J. S. Coats (UK)
Journal ArticleDOI
2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure
Piotr Ponikowski,Adriaan A. Voors,Stefan D. Anker,Héctor Bueno,John G.F. Cleland,Andrew J.S. Coats,Volkmar Falk,José Ramón González-Juanatey,Veli-Pekka Harjola,Ewa A. Jankowska,Mariell Jessup,Cecilia Linde,Petros Nihoyannopoulos,John Parissis,Burkert Pieske,Jillian P. Riley,Giuseppe M.C. Rosano,Luis M. Ruilope,Frank Ruschitzka,Frans H. Rutten,Peter van der Meer +20 more
TL;DR: ACCF/AHAIAI: angiotensin-converting enzyme inhibitor as discussed by the authors, angio-catabolizing enzyme inhibitor inhibitor inhibitor (ACS inhibitor) is a drug that is used to prevent atrial fibrillation.
Journal ArticleDOI
The effect of cardiac resynchronization on morbidity and mortality in heart failure
John G.F. Cleland,Jean-Claude Daubert,Erland Erdmann,Nick Freemantle,Daniel Gras,Lukas Kappenberger,Luigi Tavazzi +6 more
TL;DR: Cardiac resynchronization has been shown to reduce symptoms and improve left ventricular function in patients with heart failure due to systolic dysfunction and cardiac dyssynchrony.
Journal ArticleDOI
Cardiac Resynchronization in Chronic Heart Failure
William T. Abraham,Westby G. Fisher,Andrew L. Smith,David B. Delurgio,Angel R. Leon,Evan Loh,Dusan Z. Kocovic,Milton Packer,Alfredo L. Clavell,David L. Hayes,Myrvin H. Ellestad,Robin J. Trupp,Jackie Underwood,Faith Pickering,Cindy Truex,Peggy McAtee,John C. Messenger +16 more
TL;DR: Cardiac resynchronization results in significant clinical improvement in patients who have moderate-to-severe heart failure and an intraventricular conduction delay.
Journal ArticleDOI
2021 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure.
Theresa McDonagh,Marco Metra,Marianna Adamo,Roy S. Gardner,Andreas Baumbach,Michael Böhm,Haran Burri,Javed Butler,Jelena Čelutkienė,Ovidiu Chioncel,John G F Cleland,A J S Coats,Maria G Crespo-Leiro,Dimitrios Farmakis,Martine Gilard,Stephane Heymans,Arno W. Hoes,Tiny Jaarsma,Ewa A. Jankowska,Mitja Lainscak,Carolyn S.P. Lam,Alexander R. Lyon,John J.V. McMurray,Alexandre Mebazaa,Richard Mindham,Claudio Muneretto,Massimo F Piepoli,Susanna Price,Giuseppe M.C. Rosano,Frank Ruschitzka,Anne Kathrine Skibelund +30 more
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Journal Article
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Value of peak exercise oxygen consumption for optimal timing of cardiac transplantation in ambulatory patients with heart failure.
TL;DR: These data suggest that cardiac transplantation can be safely deferred in ambulatory patients with severe left ventricular dysfunction and peak exercise Vo2 of more than 14 ml/min/kg.
Journal ArticleDOI
Long-term ACE-inhibitor therapy in patients with heart failure or left-ventricular dysfunction: A systematic overview of data from individual patients
Marcus Flather,Salim Yusuf,Lars Køber,Marc A. Pfeffer,Alistair S. Hall,Gordon D Murray,Christian Torp-Pedersen,Stephen J. Ball,Janice Pogue,Lemuel A. Moyé,Eugene Braunwald +10 more
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