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Højgaard EV, Philbert BT, Linde JJ, Winsløw UC, Svendsen JH, Vinther M, Risum N. Efficacy on resynchronization and longitudinal contractile function comparing His-bundle pacing with conventional biventricular pacing: a substudy to the His-alternative study. Eur Heart J Cardiovasc Imaging 2023; 25:66-74. [PMID: 37490036 DOI: 10.1093/ehjci/jead181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 03/30/2023] [Accepted: 07/15/2023] [Indexed: 07/26/2023] Open
Abstract
AIMS His-bundle pacing has emerged as a novel method to deliver cardiac resynchronization therapy (CRT). However, there are no data comparing conventional biventricular (BiV)-CRT with His-CRT with regard to effects on mechanical dyssynchrony and longitudinal contractile function. METHODS AND RESULTS Patients with symptomatic heart failure, left ventricular ejection fraction ≤ 35%, and left bundle branch block (LBBB) by strict ECG criteria were randomized 1:1 to His-CRT or BiV-CRT. Two-dimensional strain echocardiography was performed prior to CRT implantation and at 6 months after implantation. Differences in changes in mechanical dyssynchrony (standard deviation of time-to-peak in 12 midventricular and basal segments) and regional longitudinal strain in the six left ventricular walls were compared between the BiV-CRT and His-CRT groups.In the on-treatment analysis, 31 received BiV-CRT and 19 His-CRT. In both groups, mechanical dyssynchrony was significantly reduced after 6 months [BiV group from 120 ms (±45) to 63 ms (±22), P < 0.001, and His group from 116 ms (±54) to 49 ms (±11), P < 0.001] but no significant differences in changes could be demonstrated between groups [-9.0 ms (-36; 18), P = 0.50]. Global longitudinal strain (GLS) improved in both groups [BiV group from -9.1% (±2.7) to -10.7% (±2.6), P = 0.02, and His group from -8.6% (±2.1) to -11.1% (±2.0), P < 0.001], but no significant differences in changes could be demonstrated from baseline to follow-up [-0.9% (-2.4; -0.6), P = 0.25] between groups. There were no regional differences between groups. CONCLUSION In heart failure, patients with LBBB, BiV-CRT, and His-CRT have comparable effects with regard to improvements in mechanical dyssynchrony and longitudinal contractile function.
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Affiliation(s)
- E V Højgaard
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - B T Philbert
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J J Linde
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - U C Winsløw
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - J H Svendsen
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - M Vinther
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
| | - N Risum
- Department of Cardiology, Copenhagen University Hospital, Rigshospitalet, Copenhagen, Denmark
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Singh A, Karnik R, Shah AN, Chutani S, Kantharia BK. Myocardial strain characteristics at different interventricular pacing timings: implications for device programming and long-term clinical outcomes in patients with cardiac resynchronisation therapy. Acta Cardiol 2021; 76:46-55. [PMID: 31725350 DOI: 10.1080/00015385.2019.1690261] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AIMS Response to cardiac resynchronisation therapy (CRT) in patients with heart failure depends on the degree of correction of electromechanical dyssynchrony between the left and right ventricles (LV, RV). It is not known whether chronic programming of interventricular (VV) intervals based on characterisation of myocardial strain at different pacing intervals performed acutely would have better long-term clinical outcomes. We hence aimed to evaluate this relationship between speckle tracking strain patterns and rates at different VV intervals and long-term clinical outcomes of programmed VV pacing in patients with CRT in a prospective, longitudinal follow-up study. METHODS We assessed echocardiographic effects, myocardial strain patterns and rates in acute settings at VV intervals; 'LV Off', 'VV0', 'VV60' and 'RV Off' to provide 'RV-only', 'simultaneous BiV', 'sequential LV-RV' and 'LV-only' pacing respectively in 338 patients (age, 67.5 ± 10.3 years; male, 70%) with CRT. Thereafter, devices were programmed chronically to VV60, and long-term clinical outcomes were assessed. RESULTS With VV0, VV60 and LV only pacing, LVEF improved to 33.6 ± 12.3%, 40.0 ± 11.4% and 42.6 ± 11.2%, respectively, from 23.7 ± 10.2% at baseline (p < .001). Incremental improvement in strain occurred with VV0, VV60 and LV only pacing; greatest with LV only pacing. At 1 year, 23% patients had NYHA III-IV compared to 96% at baseline (p < .001). CONCLUSIONS In patients with CRT, different VV timings show significant differences in acute myocardial strain patterns and rates, and LVEF. These changes are markedly favourable with LV-only and sequential LV-RV pacing, the latter with chronic programming also results in long-term clinical improvement.
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Affiliation(s)
- Amarnauth Singh
- Phoenix Heart Cardiovascular Consultants, Banner Thunderbird Medical Center, Glendale, AR, USA
| | - Rahool Karnik
- Phoenix Heart Cardiovascular Consultants, Banner Thunderbird Medical Center, Glendale, AR, USA
| | - Arti N. Shah
- Cardiovascular and Heart Rhythm Consultants, New York, NY, USA
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Khalifa MMM, Said A, Mortada A, Shehata H. QRS Duration as a Predictor of Left Ventricular Outflow Tract Velocity Time Integral in Patient with Cardiac Resynchronization Therapy. J Cardiovasc Echogr 2020; 30:68-74. [PMID: 33282643 PMCID: PMC7706376 DOI: 10.4103/jcecho.jcecho_66_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 12/07/2019] [Accepted: 03/31/2020] [Indexed: 11/04/2022] Open
Abstract
Background Cardiac resynchronization therapy (CRT) has a morbidity and mortality benefits in moderate to severe heart failure. It reduces mortality and hospitalization and improves cardiac function. It can be used according to the European guidelines in severely depressed left ventricular ejection fraction (i.e., ≤35%) and complete left bundle branch block. However, 30% of patients may show no benefit from CRT therapy. Therefore, prediction of CRT response seems to be an important subject for study in the current researches. We aimed to study the correlation between Surface ECG QRS complex duration (QRS) duration and cardiac output measured by ventricular outflow tract velocity time integral (LVOT VTI) as a predictor of response in patients with CRT implantation. Methods We studied 100 consecutive patients prospectively with biventricular pacing system. The patients were studied at the pacemaker follow-up clinic. Each patient was subjected to: Full medical history, general and local examination, a 12 lead electrocardiogram and QRS duration in ms was measured. All patients were subjected to a focused transthoracic echocardiographic examination in which a parasternal long axis view was obtained to measure the diameter of the LVOT diameter in mid-systole. The LVOT VTI was measured by pulsed-wave Doppler in the LVOT using a 2-mm sample volume positioned just proximal to the aortic valve in the apical five chamber view. Results We found a statistically significant difference between CRT responders and nonresponders as regards age, body surface area (BSA), time since CRT implantation and smoking status (P = 0.018, 0.039, 0.002, <0.001). There was negative significant correlation between QRS duration and LVOT VTI and stroke volume index. The optimal cut off values for optimal response to CRT using receiver operating characteristics curves were 130 ms for postimplant QRS duration and 17.1 cm for LVOT VTI. We also found a significant difference between responders and nonresponders as regard CO. It was higher in responders (5.97 vs. 3.34, P < 0.001). Conclusion CRT response is more in patients with lower BSA, and without previous history of ischemic heart disease or smoking. There is a significant negative correlation between QRS duration and LVOT VTI.
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Affiliation(s)
| | - Ahmed Said
- Department of Cardiology, Ain Shams University Hospital, Cairo, Egypt
| | - Ayman Mortada
- Department of Cardiology, Ain Shams University Hospital, Cairo, Egypt
| | - Hassan Shehata
- Department of Cardiology, Ain Shams University Hospital, Cairo, Egypt
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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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Yaman B, Kemal HS, Dönmez Y, Cerit L, Usalp S, Yüksek Ü, Günsel A, Duygu H, Akpınar O. Improvement of abnormal systolic motion of the interventricular septum with cardiac resynchronization therapy. PACING AND CLINICAL ELECTROPHYSIOLOGY: PACE 2019; 42:1213-1218. [PMID: 31390077 DOI: 10.1111/pace.13772] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 07/18/2019] [Accepted: 08/04/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND There is no consensus in the literature regarding what is the responsible mechanism of left ventricular dyssynchrony; septal dyskinesia or late movement of left ventricle (LV) lateral wall. We aim to evaluate the abnormal systolic motion in each myocardial segment and the improvement of LV systolic function with pulsed tissue Doppler imaging (TDI) in patients undergoing cardiac resynchronization therapy (CRT) with left bundle branch block (LBBB). METHODS A total of 26 patients undergoing CRT implantation with LBBB, wide QRS duration (≥120 ms), and low ejection fraction (EF) (<35%) were included. Pulsed TDI was taken from apical 4-chamber view and parasternal short axis view (PSAX). All echocardiographic parameters were measured when CRT is on and off. RESULTS Systolic ejection time (ET) of anteroseptal and posterolateral wall of LV in PSAX was statistically significantly longer in CRT on group (321.6 ± 62.7 vs 237.5 ± 59.3 ms, P < .001; 323.9 ± 58.0 vs 289.4 ± 43.7 ms, P = .015, respectively). In apical 4-chamber view, septal annulus systolic ET is significantly longer in CRT on group than CRT off group (315.8 ± 57.2 vs 287.3 ± 42.2, P = .014). Also, there was a strong correlation between systolic ET of the septum in PSAX with aortic velocity time integral (VTI), QRS duration and EF (r = .587, P = .002; r = .479, P = .013; r = .440, P = .025; respectively). CONCLUSION Circumferential contraction of septal myocardial fibers is improved with CRT and it is strongly correlated with increase of aortic VTI and shortening of QRS duration. These findings predict the deterioration of septal contraction as the main mechanism in patients with LBBB pattern and, CRT may improves myocardial contraction by correcting septal systolic motion.
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Affiliation(s)
- Belma Yaman
- Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Hatice S Kemal
- Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Yurdaer Dönmez
- Department of Cardiology, Adana City Training and Research Hospital, Adana, Turkey
| | - Levent Cerit
- Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Songül Usalp
- Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Ümit Yüksek
- Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Aziz Günsel
- Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Hamza Duygu
- Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus
| | - Onur Akpınar
- Department of Cardiology, Near East University Faculty of Medicine, Nicosia, Cyprus
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Cardiac resynchronisation therapy optimisation of interventricular delay by the systolic dyssynchrony index: A comparative, randomised, 12-month follow-up study. Hellenic J Cardiol 2019; 60:16-25. [DOI: 10.1016/j.hjc.2017.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Revised: 10/29/2017] [Accepted: 11/01/2017] [Indexed: 11/23/2022] Open
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Rowe MK, Kaye GC. Advances in atrioventricular and interventricular optimization of cardiac resynchronization therapy - what's the gold standard? Expert Rev Cardiovasc Ther 2018; 16:183-196. [PMID: 29338475 DOI: 10.1080/14779072.2018.1427582] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
INTRODUCTION Cardiac resynchronization therapy (CRT) is one of the most important advances in heart failure management in the last twenty years. Approximately one-third of patients appear not to respond to therapy. Although there are a number of possible mechanisms for non-response, an important factor is suboptimal atrioventricular (AV) and interventricular (VV) timing intervals. There remains controversy over whether routinely optimizing intervals is necessary and there is no agreed gold standard methodology. Optimization has classically been performed using echocardiography which has limits related to resource use, time-cost and variable reproducibility. Newer optimization methods using device-based sensors and algorithms show promise in reducing heart-failure hospitalization compared with echocardiography. Areas covered: This review outlines the rationale for optimization, the principles of AV and VV optimization, the standard echocardiographic approach and newer device-based algorithms and the evidence base for their use. Expert commentary: The incremental gains of optimization are likely to be real, but small, compared to the overall improvement gained from cardiac resynchronization itself. At this time routine optimization may not be mandatory but should be performed where there is no response to CRT. Device-based optimization algorithms appear to be practical and in some cases, deliver superior clinical outcomes compared to echocardiography.
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Affiliation(s)
- Matthew K Rowe
- a Department of Cardiology , Princess Alexandra Hospital , Brisbane , Australia.,b Faculty of Medicine , The University of Queensland , Brisbane , Australia
| | - Gerald C Kaye
- a Department of Cardiology , Princess Alexandra Hospital , Brisbane , Australia.,b Faculty of Medicine , The University of Queensland , Brisbane , Australia
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Risum N, Tayal B, Hansen TF, Bruun NE, Jensen MT, Lauridsen TK, Saba S, Kisslo J, Gorcsan J, Sogaard P. Identification of Typical Left Bundle Branch Block Contraction by Strain Echocardiography Is Additive to Electrocardiography in Prediction of Long-Term Outcome After Cardiac Resynchronization Therapy. J Am Coll Cardiol 2016; 66:631-41. [PMID: 26248989 DOI: 10.1016/j.jacc.2015.06.020] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Revised: 05/07/2015] [Accepted: 06/02/2015] [Indexed: 11/26/2022]
Abstract
BACKGROUND Current guidelines suggest that patients with left bundle branch block (LBBB) be treated with cardiac resynchronization therapy (CRT); however, one-third do not have a significant activation delay, which can result in nonresponse. By identifying characteristic opposing wall contraction, 2-dimensional strain echocardiography (2DSE) may detect true LBBB activation. OBJECTIVES This study sought to investigate whether the absence of a typical LBBB mechanical activation pattern by 2DSE was associated with unfavorable long-term outcome and if this is additive to electrocardiographic (ECG) morphology and duration. METHODS From 2 centers, 208 CRT candidates (New York Heart Association classes II to IV, ejection fraction ≤35%, QRS duration ≥120 ms) with LBBB by ECG were prospectively included. Before CRT implantation, longitudinal strain in the apical 4-chamber view determined whether typical LBBB contraction was present. The pre-defined outcome was freedom from death, left ventricular assist device, or heart transplantation over 4 years. RESULTS Two-thirds of patients (63%) had a typical LBBB contraction pattern. During 4 years, 48 patients (23%) reached the primary endpoint. Absence of a typical LBBB contraction was independently associated with increased risk of adverse outcome after adjustment for ischemic heart disease and QRS width (hazard ratio [HR]: 3.1; 95% CI: 1.64 to 5.88; p < 0.005). Adding pattern assessment to a risk prediction model including QRS duration and ischemic heart disease significantly improved the net reclassification index to 0.14 (p = 0.04) and improved the C-statistics (0.63 [95% CI: 0.54 to 0.72] vs. 0.71 [95% CI: 0.63 to 0.80]; p = 0.02). Use of strict LBBB ECG criteria was not independently associated with outcome in the multivariate model (HR: 1.72; 95% CI: 0.89 to 3.33; p = 0.11. Assessment of LBBB contraction pattern was superior to time-to-peak indexes of dyssynchrony (p < 0.01 for all). CONCLUSIONS Contraction pattern assessment to identify true LBBB activation provided important prognostic information in CRT candidates.
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Affiliation(s)
- Niels Risum
- Department of Cardiology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark.
| | - Bhupendar Tayal
- Division of Cardiology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Cardiology and Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
| | - Thomas F Hansen
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
| | - Niels E Bruun
- Division of Cardiology, University of Pittsburgh, Pittsburgh, Pennsylvania; Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
| | | | - Trine K Lauridsen
- Department of Cardiology, Gentofte University Hospital, Hellerup, Denmark
| | - Samir Saba
- Division of Cardiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Joseph Kisslo
- Division of Cardiovascular Medicine, Duke University Medical Center, Durham, North Carolina
| | - John Gorcsan
- Division of Cardiology, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Peter Sogaard
- Department of Cardiology and Clinical Medicine, Aalborg University Hospital, Aalborg, Denmark
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Leischik R, Dworrak B, Sanchis-Gomar F, Lucia A, Buck T, Erbel R. Echocardiographic assessment of myocardial ischemia. ANNALS OF TRANSLATIONAL MEDICINE 2016; 4:259. [PMID: 27500160 DOI: 10.21037/atm.2016.07.06] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Over the last 60 years, echocardiography has emerged as a dominant and indispensable technique for the detection and assessment of coronary heart disease (CHD). In this review, we will describe and discuss this powerful tool of cardiology, especially in the hands of an experienced user, with a focus on myocardial ischemia. Technical development is still on-going, and various new ultrasound techniques have been established in the field of echocardiography in the last several years, including tissue Doppler imaging (TDI), contrast echocardiography, three-dimensional echocardiography (3DE), and speckle tracking echocardiography (i.e., strain/strain rate-echocardiography). High-end equipment with harmonic imaging, high frame rates and the opportunity to adjust mechanical indices has improved imaging quality. Like all new techniques, these techniques must first be subjected to comprehensive scientific assessment, and appropriate training that accounts for physical and physiological limits should be provided. These limits will constantly be redefined as echocardiographic techniques continue to change, which will present new challenges for the further development of ultrasound technology.
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Affiliation(s)
- Roman Leischik
- Faculty of Health, School of Medicine, University Witten/Herdecke, Hagen, Germany
| | - Birgit Dworrak
- Faculty of Health, School of Medicine, University Witten/Herdecke, Hagen, Germany
| | | | - Alejandro Lucia
- Research Institute Hospital 12 de Octubre ("i+12"), Madrid, Spain;; European University of Madrid, Madrid, Spain
| | - Thomas Buck
- Clinic of Cardiology, Klinikum Westfalen, Dortmund, Germany
| | - Raimund Erbel
- Institute of Medical Informatics, Biometry, Epidemiology, University Clinic Essen, Essen, Germany
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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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Cardiac resynchronization therapy: Identifying an activation delay by regional strain analysis. J Electrocardiol 2015; 48:779-82. [DOI: 10.1016/j.jelectrocard.2015.07.020] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2015] [Indexed: 11/19/2022]
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Emerek K, Risum N, Hjortshøj S, Riahi S, Rasmussen JG, Bloch Thomsen PE, Graff C, Søgaard P. New strict left bundle branch block criteria reflect left ventricular activation differences. J Electrocardiol 2015; 48:758-62. [DOI: 10.1016/j.jelectrocard.2015.07.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Indexed: 12/12/2022]
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Echocardiographic Evaluation of Left Atrial Mechanics: Function, History, Novel Techniques, Advantages, and Pitfalls. BIOMED RESEARCH INTERNATIONAL 2015; 2015:765921. [PMID: 26236735 PMCID: PMC4508385 DOI: 10.1155/2015/765921] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/24/2015] [Accepted: 02/08/2015] [Indexed: 01/04/2023]
Abstract
Left atrial (LA) functional analysis has an established role in assessing left ventricular diastolic function. The current standard echocardiographic parameters used to study left ventricular diastolic function include pulsed-wave Doppler mitral inflow analysis, tissue Doppler imaging measurements, and LA dimension estimation. However, the above-mentioned parameters do not directly quantify LA performance. Deformation studies using strain and strain-rate imaging to assess LA function were validated in previous research, but this technique is not currently used in routine clinical practice. This review discusses the history, importance, and pitfalls of strain technology for the analysis of LA mechanics.
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Sagara K. Ventriculoventricular delay optimization of a cardiac resynchronization device. J Arrhythm 2014. [DOI: 10.1016/j.joa.2014.03.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
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