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Laczay B, Patel D, Grimm R, Xu B. State-of-the-art narrative review: multimodality imaging in electrophysiology and cardiac device therapies. Cardiovasc Diagn Ther 2021; 11:881-895. [PMID: 34295711 DOI: 10.21037/cdt-20-724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 11/30/2020] [Indexed: 12/07/2022]
Abstract
Cardiac electrophysiology procedures have evolved to provide improvement in morbidity and mortality for many patients. Cardiac resynchronization therapy (CRT), implantable cardioverter/defibrillator (ICD) placement and lead extraction procedures are proven procedures, associated with significant reductions in patient morbidity and mortality as well as improved quality of life. The applications and optimization of these therapies are an evolving field. The optimal use and outcomes of cardiac electrophysiology procedures require a multidisciplinary approach to patient selection, device selection, and procedural planning. Cardiac imaging using echocardiography plays a key role in selection of patients for CRT therapy, for guidance of left ventricular (LV) lead placement, and for optimization of atrioventricular pacing delays in patients with CRT. Cardiac computed tomography (CT) is an important tool in assessment of lead perforation, as well as assessing risk of lead extraction and procedural planning. Cardiac magnetic resonance imaging (MRI) is an important adjunct to transthoracic echocardiography for patient selection and risk stratification for defibrillator therapy for multiple disease states including ischemic cardiomyopathy, hypertrophic cardiomyopathy, cardiac sarcoidosis, and arrhythmogenic right ventricular cardiomyopathy (ARVC). Cardiac positron emission tomography (PET) is a useful adjunct to the diagnosis of device infections as well as inflammatory conditions including cardiac sarcoidosis. Our review attempts to summarize the contemporary roles of multimodality imaging in CRT therapy, ICD therapy and lead extraction therapy.
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Affiliation(s)
- Balint Laczay
- Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Divyang Patel
- Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Richard Grimm
- Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Bo Xu
- Heart, Vascular & Thoracic Institute, Cleveland Clinic Foundation, Cleveland, OH, USA
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2
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Cardiovascular Imaging Applications in Clinical Management of Patients Treated with Cardiac Resynchronization Therapy. HEARTS 2020. [DOI: 10.3390/hearts1030017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Cardiovascular imaging techniques, including echocardiography, nuclear cardiology, multi-slice computed tomography, and cardiac magnetic resonance, have wide applications in cardiac resynchronization therapy (CRT). Our aim was to provide an update of cardiovascular imaging applications before, during, and after implantation of a CRT device. Before CRT implantation, cardiovascular imaging techniques may integrate current clinical and electrocardiographic selection criteria in the identification of patients who may most likely benefit from CRT. Assessment of myocardial viability by ultrasound, nuclear cardiology, or cardiac magnetic resonance may guide optimal left ventricular (LV) lead positioning and help to predict LV function improvement by CRT. During implantation, echocardiographic techniques may guide in the identification of the best site of LV pacing. After CRT implantation, cardiovascular imaging plays an important role in the assessment of CRT response, which can be defined according to LV reverse remodeling, function and dyssynchrony indices. Furthermore, imaging techniques may be used for CRT programming optimization during follow-up, especially in patients who turn out to be non-responders. However, in the clinical settings, the use of proposed functional indices for different imaging techniques is still debated, due to their suboptimal feasibility and reproducibility. Moreover, identifying CRT responders before implantation and turning non-responders into responders at follow-up remain challenging issues.
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Yenerçağ M, Yüksel S, Çoksevim M, Akçay M, Arslan U. Noninvasive cardiac output measurement based optimization in nonresponders of cardiac resynchronization therapy. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2020; 43:394-401. [PMID: 32198929 DOI: 10.1111/pace.13904] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Revised: 03/03/2020] [Accepted: 03/15/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND Cardiac resynchronization therapy (CRT) is an important and effective therapy for end-stage heart failure (HF). Nonresponse to CRT is one of the main obstacles to its application in clinical practice. Herein, we investigated the utilization of the optimization technique using noninvasive cardiac output measurement (NICOM) based Mobil-O-Graph device that measures several circulation parameters noninvasively. METHODS Seventy-five CRT nonresponder HF patients with an implanted CRT device were included. Patients were randomized equally to 3 groups: NICOM, echocardiographic, and empirical optimization groups. After 3 months of optimization, changes in six minutes walk test (6-MWT), cardiac output (CO), left ventricular ejection fraction (LVEF), and end-systolic volume (LVESV) were measured. New York Heart Association (NYHA) class and hospitalization for HF were also determined. RESULTS There were no statistically significant differences among the three groups in terms of demographics, baseline characteristics. In the NICOM group, the 6-MWT, LVEF, CO, and LVESV measurements showed significant improvements compared to baseline values (P < .05). There was no significant improvement in 6-MWT, LVEF, CO, NYHA class, and LVESV in Echo and Empirical groups after 3 months (P > .05). 6-MWT, CO, LVESV percentages, and hospitalization for HF were significantly different between the groups (P < .05). In post hoc analyzes, the percentages of the change in 6-MWT, CO, LVESV, and hospitalization for HF were significantly higher in the NICOM group (P < .017). CONCLUSIONS This study suggests that Mobil-O-Graph device optimization according to CO measures does appear to have potential hemodynamic and clinical benefits in nonresponder CRT patients. Use of Mobil-O-Graph device as an option for optimization of CRT devices can be an attractive method of improving CRT outcomes.
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Affiliation(s)
- Mustafa Yenerçağ
- Department of Cardiology, University of Health Sciences, Samsun Training and Research Hospital, Samsun, Turkey
| | - Serkan Yüksel
- Department of Cardiology, Ondokuz Mayıs University Hospital, Samsun, Turkey
| | - Metin Çoksevim
- Department of Cardiology, Ondokuz Mayıs University Hospital, Samsun, Turkey
| | - Murat Akçay
- Department of Cardiology, Ondokuz Mayıs University Hospital, Samsun, Turkey
| | - Uğur Arslan
- Department of Cardiology, University of Health Sciences, Samsun Training and Research Hospital, Samsun, Turkey
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Šipula D, Kozák M, Šipula J, Homza M, Plášek J. Cardiac Strains As a Tool for Optimization of Cardiac Resynchronization Therapy in Non-responders: a Pilot Study. Open Med (Wars) 2020; 14:945-952. [PMID: 31934639 PMCID: PMC6947762 DOI: 10.1515/med-2019-0111] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Accepted: 07/30/2019] [Indexed: 11/16/2022] Open
Abstract
Background Approximately 30% of patients do not respond to implantation of Cardiac Resynchronization Therapy – Defibrillators (CRT-D). The aim of this study was to investigate the potential for cardiac strain speckle tracking to optimize the performance of CRT-D in non-responding patients. Methods 30 patients not responding to Cardiac Resynchronization Therapy-Defibrillators after 3 months were randomly divided into control and intervention groups. Atrioventricular interval was adjusted so that E and A waves did not overlap, the interventricular interval was subsequently optimized to yield maximum improvement of the sum of longitudinal+radial+circumferential strains. The left ventricular ejection fraction (LVEF) and NYHA improvement 3 months after optimization were evaluated and use of other strain combinations assessed. Results A significant correlation between the (combined) strain change and LVEF improvement was detected (p<0.01). 75% of patients with non-ischemic etiology of heart failure who did not respond to the original CRT-D reacted favorably with significant LVEF and NYHA improvement. The area strain was the best predictor of LVEF/NYHA improvement in those patients. No significant improvement was recorded in patients with ischemic etiology. Conclusions AV and VV optimization based on speckle tracking is a very promising method potentially leading to a significant improvement of the outcome of CRT-D, especially in patients with non-ischemic etiology of heart failure.
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Affiliation(s)
- David Šipula
- Department of Cardiovascular Diseases, University Hospital in Ostrava, 17. listopadu 1790, 708 00 Ostrava, Czech Republic.,Faculty of Medicine, Masaryk University Brno, Kamenice 5, 625 00 Brno, Czech Republic
| | - Milan Kozák
- Faculty of Medicine, Masaryk University Brno, Kamenice 5, 625 00 Brno, Czech Republic.,Clinic of Internal Medicine - Cardiology, University Hospital Brno, 625 00, Czech Republic
| | - Jaroslav Šipula
- Department of Cardiovascular Diseases, University Hospital in Ostrava, 17. listopadu 1790, 708 00 Ostrava, Czech Republic
| | - Miroslav Homza
- Department of Cardiovascular Diseases, University Hospital in Ostrava, 17. listopadu 1790, 708 00 Ostrava, Czech Republic
| | - Jiří Plášek
- Department of Cardiovascular Diseases, University Hospital in Ostrava, 17. listopadu 1790, 708 00 Ostrava, Czech Republic
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Zaky A, Beck A, Rooke GA. Hemodynamically Significant Heart Block After Carotid Artery Stenting in a Patient With Atrial Demand Pacer-Echocardiography-Guided Rescue Pacing. J Cardiothorac Vasc Anesth 2019; 34:187-191. [PMID: 31526556 DOI: 10.1053/j.jvca.2019.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Revised: 08/17/2019] [Accepted: 08/19/2019] [Indexed: 11/11/2022]
Affiliation(s)
- Ahmed Zaky
- Department of Anesthesiology and Perioperative Medicine, University of Alabama at Birmingham, AL.
| | - Adam Beck
- Department of Vascular Surgery, University of Alabama at Birmingham, AL
| | - G Alec Rooke
- Department of Anesthesiology and Pain Medicine, University of Washington, Seattle, WA
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Echocardiography for the management of patients with biventricular pacing: Possible roles in cardiac resynchronization therapy implementation. Hellenic J Cardiol 2018; 59:306-312. [PMID: 29452309 DOI: 10.1016/j.hjc.2018.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2017] [Revised: 02/03/2018] [Accepted: 02/06/2018] [Indexed: 11/20/2022] Open
Abstract
Cardiac resynchronization therapy (CRT) is an established therapeutic option for the subset of patients with heart failure (HF), reduced ejection fraction (EF), and dyssynchrony evidenced by electrocardiography. Benefit from CRT has been proven in many clinical trials, yet a sizeable proportion of these patients with wide QRS do not respond to this intervention, despite the updated practice guidelines. Several echocardiographic indices, targeting mechanical rather than electrical dyssynchrony, have been suggested to address this issue, but research so far has not succeeded in providing a single and simple measurement with adequate sensitivity and specificity for identification of responders. While there is still ongoing research in this field, echocardiography proves helpful in other aspects of CRT implementation, such as site selection for left ventricular (LV) lead pacing and optimization of pacing parameters during follow-up visits.
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Marek J, Gandalovičová J, Kejřová E, Pšenička M, Linhart A, Paleček T. Echocardiography and cardiac resynchronization therapy. COR ET VASA 2016. [DOI: 10.1016/j.crvasa.2015.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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8
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Beyond auscultation: Acoustic cardiography in clinical practice. Int J Cardiol 2014; 172:548-60. [DOI: 10.1016/j.ijcard.2013.12.298] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2013] [Accepted: 12/30/2013] [Indexed: 11/24/2022]
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Stanton T, Haluska BA, Leano R, Marwick TH. Hemodynamic benefit of rest and exercise optimization of cardiac resynchronization therapy. Echocardiography 2014; 31:980-8. [PMID: 24447181 DOI: 10.1111/echo.12506] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
The optimal method of cardiac resynchronization therapy (CRT) optimization is as yet unknown. We sought to investigate the responses of optimization at rest and on exercise. This 2 stage study involved 59 patients (age 65 ± 10, 75% male), who had all recently undergone successful CRT implantation. In the first stage, the 6-month response was compared between 30 individuals who underwent resting echocardiographic optimization of CRT [atrioventricular (AV delay) plus ventriculo-ventricular delays (VV delay)], compared with the 29 who did not. In the second stage, a subset of 37 patients from the original cohort were randomized (double-blind) to either resting echocardiographic optimization (n = 20) or exercise echocardiographic optimization (n = 17) and followed for a further 6 months. Clinical and echocardiographic data were collected at each stage. Patients undergoing rest optimization demonstrated improvement in almost all variables and significantly in B-type natriuretic peptide (BNP) in contrast to those without optimization. In a linear regression model, the only significant predictor of BNP change was whether an individual underwent resting optimization or not (β = 0.38, P = 0.04). In those undergoing resting optimization, the degree of change in AV delay was correlated with improvement in left ventricle (LV) end-diastolic volume (r(2) = 0.33, P < 0.01). Optimization on exercise was associated with a significant decrease in 6-minute walk test compared to those randomized to rest optimization possibly due to inducing nonoptimization at rest. In conclusion, echocardiographic optimization of CRT at rest is superior to no optimization or optimization on exercise. Patients with the greatest change in AV delay to reach optimal may undergo greater LV remodeling.
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Nayar V, Khan FZ, Pugh PJ. Optimizing atrioventricular and interventricular intervals following cardiac resynchronization therapy. Expert Rev Cardiovasc Ther 2014; 9:185-97. [DOI: 10.1586/erc.10.187] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Sohaib SMA, Whinnett ZI, Ellenbogen KA, Stellbrink C, Quinn TA, Bogaard MD, Bordachar P, van Gelder BM, van Geldorp IE, Linde C, Meine M, Prinzen FW, Turcott RG, Spotnitz HM, Wichterle D, Francis DP. Cardiac resynchronisation therapy optimisation strategies: systematic classification, detailed analysis, minimum standards and a roadmap for development and testing. Int J Cardiol 2013; 170:118-31. [PMID: 24239155 DOI: 10.1016/j.ijcard.2013.10.069] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2013] [Revised: 09/19/2013] [Accepted: 10/19/2013] [Indexed: 01/23/2023]
Abstract
In this article an international group of CRT specialists presents a comprehensive classification system for present and future schemes for optimising CRT. This system is neutral to the measurement technology used, but focuses on little-discussed quantitative physiological requirements. We then present a rational roadmap for reliable cost-effective development and evaluation of schemes. A widely recommended approach for AV optimisation is to visually select the ideal pattern of transmitral Doppler flow. Alternatively, one could measure a variable (such as Doppler velocity time integral) and "pick the highest". More complex would be to make measurements across a range of settings and "fit a curve". In this report we provide clinicians with a critical approach to address any recommendations presented to them, as they may be many, indistinct and conflicting. We present a neutral scientific analysis of each scheme, and equip the reader with simple tools for critical evaluation. Optimisation protocols should deliver: (a) singularity, with only one region of optimality rather than several; (b) blinded test-retest reproducibility; (c) plausibility; (d) concordance between independent methods; and (e) transparency, with all steps open to scrutiny. This simple information is still not available for many optimisation schemes. Clinicians developing the habit of asking about each property in turn will find it easier to win now down the broad range of protocols currently promoted. Expectation of a sophisticated enquiry from the clinical community will encourage optimisation protocol-designers to focus on testing early (and cheaply) the basic properties that are vital for any chance of long term efficacy.
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Affiliation(s)
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- National Heart & Lung Institute, Imperial College London, UK.
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12
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Applicability of the iterative technique for cardiac resynchronization therapy optimization: full-disclosure, 50-sequential-patient dataset of transmitral Doppler traces, with implications for future research design and guidelines. ACTA ACUST UNITED AC 2013; 16:541-50. [DOI: 10.1093/europace/eut257] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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13
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Cardiac resynchronization therapy mechanisms in atrial fibrillation. Heart Fail Clin 2013; 9:475-88, ix. [PMID: 24054480 DOI: 10.1016/j.hfc.2013.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
This article examines how to assess the reliability of potential techniques for performing optimization of biventricular pacemakers in patients with atrial fibrillation. It explores the magnitude of improvement that is likely to be obtained with the optimization of biventricular pacing in this clinical setting and discusses the lessons that can be learned with regard to the mechanisms of action of biventricular pacing in the general heart failure population.
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Lee MS, Naqvi TZ. Echocardiography-guided pacemaker programming can improve cardiac hemodynamics in patients undergoing transcatheter aortic valve replacement. Echocardiography 2013; 30:853-7. [PMID: 23627861 DOI: 10.1111/echo.12223] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Transcatheter aortic valve replacement (TAVR) is an effective treatment option for patients with severe aortic stenosis who are at high surgical risk because of multiple comorbidities. Many of these patients have been treated with pacemakers for concomitant conduction disease. The combination of severe aortic stenosis, cardiomyopathy, and conduction abnormalities results in a state of low cardiac output. Here, we report 2 complex TAVR cases where Doppler echocardiography was used to guide adjustment of device settings, leading to improved cardiac hemodynamic profiles.
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Affiliation(s)
- Ming-Sum Lee
- Division of Cardiology, Department of Medicine, Cardiac Non Invasive Laboratories, Keck School of Medicine, University of Southern California, Los Angeles, California 90033, USA
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Francis DP. How to reliably deliver narrow individual-patient error bars for optimization of pacemaker AV or VV delay using a “pick-the-highest” strategy with haemodynamic measurements. Int J Cardiol 2013; 163:221-225. [DOI: 10.1016/j.ijcard.2012.03.128] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2012] [Accepted: 03/12/2012] [Indexed: 11/16/2022]
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Decloedt A, Verheyen T, Sys S, De Clercq D, Bijnens B, van Loon G. Influence of Atrioventricular Interaction on Mitral Valve Closure and Left Ventricular Isovolumic Contraction Measured by Tissue Doppler Imaging. Circ Cardiovasc Imaging 2013. [DOI: 10.1161/circimaging.112.978692] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Annelies Decloedt
- From the Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Gent, Belgium (A.D., T.V., S.S., D.D.C., G.v.L.); and ICREA-Universitat Pompeu Fabra, Barcelona, Spain (B.B.)
| | - Tinne Verheyen
- From the Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Gent, Belgium (A.D., T.V., S.S., D.D.C., G.v.L.); and ICREA-Universitat Pompeu Fabra, Barcelona, Spain (B.B.)
| | - Stanislas Sys
- From the Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Gent, Belgium (A.D., T.V., S.S., D.D.C., G.v.L.); and ICREA-Universitat Pompeu Fabra, Barcelona, Spain (B.B.)
| | - Dominique De Clercq
- From the Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Gent, Belgium (A.D., T.V., S.S., D.D.C., G.v.L.); and ICREA-Universitat Pompeu Fabra, Barcelona, Spain (B.B.)
| | - Bart Bijnens
- From the Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Gent, Belgium (A.D., T.V., S.S., D.D.C., G.v.L.); and ICREA-Universitat Pompeu Fabra, Barcelona, Spain (B.B.)
| | - Gunther van Loon
- From the Department of Large Animal Internal Medicine, Faculty of Veterinary Medicine, Ghent University, Gent, Belgium (A.D., T.V., S.S., D.D.C., G.v.L.); and ICREA-Universitat Pompeu Fabra, Barcelona, Spain (B.B.)
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CUOCO FRANKA, GOLD MICHAELR. Optimization of Cardiac Resynchronization Therapy: Importance of Programmed Parameters. J Cardiovasc Electrophysiol 2011; 23:110-8. [DOI: 10.1111/j.1540-8167.2011.02235.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Sung RK, Foster E. Assessment of Systolic Dyssynchrony for Cardiac Resynchronization Therapy Is Not Clinically Useful. Circulation 2011; 123:656-62. [DOI: 10.1161/circulationaha.110.954420] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Raphael K. Sung
- From the Division of Cardiology, University of California, San Francisco
| | - Elyse Foster
- From the Division of Cardiology, University of California, San Francisco
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Higuchi R, Tada H, Okaniwa H, Nakajima T, Takemura N, Fuke E, Sato C, Hayashi T, Miki Y, Sakamoto T, Fukasawa R, Kumagai K, Naito S, Oshima S. Utility and Validation of Corrected Left Ventricular Filling Time for Determining the Optimal AV Delay in Patients Receiving Cardiac Resynchronization Therapy. J Arrhythm 2011. [DOI: 10.1016/s1880-4276(11)80019-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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20
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Shen X, Aronow WS, Nair CK, Holmberg MJ, Hee T, Maciejewski S, Esterbrooks DJ. Are the Extent, Location, and Score of Segmental Wall Motion Abnormalities Related to Cardiac Resynchronization Therapy Response? Echocardiography 2009; 26:1136-45. [PMID: 19725853 DOI: 10.1111/j.1540-8175.2009.00961.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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