Fusion CRT pacing: septal flash significance in super responder patients. (3rd October 2022)
- Record Type:
- Journal Article
- Title:
- Fusion CRT pacing: septal flash significance in super responder patients. (3rd October 2022)
- Main Title:
- Fusion CRT pacing: septal flash significance in super responder patients
- Authors:
- Vacarescu, C
Luca, C T
Gaita, D
Crisan, S
Mornos, C
Goanta, E V
Lazar, M A
Ionac, I
Arnautu, D A
Cozma, D - Abstract:
- Abstract: Background: LV only CRT pacing is an option that may be considered to maximize response to CRT and at least as an alternative in non-responders to biventricular (BiV) pacing. However, criteria to best titrate therapy on an individual basis are lacking in fusion pacing. On the other hand, septal flash (SF) is a strong predictor of favorable response for patients (pts) with BiV pacing. Purpose: To analyze the relationship between SF and the response to fusion CRT pacing. Methods: Consecutive pts with exclusive fusion CRT-P were included. Right atrium/left ventricle leads DDD CRT pacing system were used in all patients. Prospective data were collected at every 6 months follow-up visits: device interrogation, exercise test, echocardiographic parameters. Exercise tests, device reprogramming and medication optimization were performed regular in order to maximize CRT response. Patients were divided in 2 groups: super-responders (SR) and responders (R). SRs were defined those with left ventricular end-systolic volume (LVESV) improvement ≥30% and stable ejection fraction (LVEF) ≥45%. Results: 69 pts with NYHA II–III heart failure and non-ischemic dilated cardiomyopathy were initially included. 5 pts were non responders and excluded (non LBBB, spontaneous QRS <149 ms). Final analyzed group had 64 pts (35 male) aged 60±12 y.o. The mean follow-up was 54±19 months; 22 pts (34%) were SRs. At baseline, SF was found in all SR pts and in 55% of R pts. SF was corrected post CRT inAbstract: Background: LV only CRT pacing is an option that may be considered to maximize response to CRT and at least as an alternative in non-responders to biventricular (BiV) pacing. However, criteria to best titrate therapy on an individual basis are lacking in fusion pacing. On the other hand, septal flash (SF) is a strong predictor of favorable response for patients (pts) with BiV pacing. Purpose: To analyze the relationship between SF and the response to fusion CRT pacing. Methods: Consecutive pts with exclusive fusion CRT-P were included. Right atrium/left ventricle leads DDD CRT pacing system were used in all patients. Prospective data were collected at every 6 months follow-up visits: device interrogation, exercise test, echocardiographic parameters. Exercise tests, device reprogramming and medication optimization were performed regular in order to maximize CRT response. Patients were divided in 2 groups: super-responders (SR) and responders (R). SRs were defined those with left ventricular end-systolic volume (LVESV) improvement ≥30% and stable ejection fraction (LVEF) ≥45%. Results: 69 pts with NYHA II–III heart failure and non-ischemic dilated cardiomyopathy were initially included. 5 pts were non responders and excluded (non LBBB, spontaneous QRS <149 ms). Final analyzed group had 64 pts (35 male) aged 60±12 y.o. The mean follow-up was 54±19 months; 22 pts (34%) were SRs. At baseline, SF was found in all SR pts and in 55% of R pts. SF was corrected post CRT in all patients, except one. For this patient (LV lead in a posterior branch of the coronary sinus – CS) the strategy included an upgrade to triple chamber device with a second lead in a lateral branch of the CS and became SR from R. Mitral regurgitation decreased in 38 patients (all SR, 40% R). Interesting, baseline left atrium volume and pulmonary sistolic artery pressure were smaller in SR versus R group, however SF did not corelate with LA volume/diastolic dysfunction. Conclusions: Septal flash seems to be a strong predictor of super-response in patients with fusion CRT pacing. This finding could improve the selection of candidates for fusion CRT-P, however larger studies are needed to assess SF in this categories of patients. Funding Acknowledgement: Type of funding sources: None. … (more)
- Is Part Of:
- European heart journal. Volume 43(2022)Supplement 2
- Journal:
- European heart journal
- Issue:
- Volume 43(2022)Supplement 2
- Issue Display:
- Volume 43, Issue 2 (2022)
- Year:
- 2022
- Volume:
- 43
- Issue:
- 2
- Issue Sort Value:
- 2022-0043-0002-0000
- Page Start:
- Page End:
- Publication Date:
- 2022-10-03
- Subjects:
- Cardiology -- Periodicals
Heart -- Diseases -- Periodicals
616.12005 - Journal URLs:
- http://eurheartj.oxfordjournals.org/ ↗
http://ukcatalogue.oup.com/ ↗ - DOI:
- 10.1093/eurheartj/ehac544.999 ↗
- Languages:
- English
- ISSNs:
- 0195-668X
- Deposit Type:
- Legaldeposit
- View Content:
- Available online (eLD content is only available in our Reading Rooms) ↗
- Physical Locations:
- British Library DSC - 3829.717500
British Library DSC - BLDSS-3PM
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- 24444.xml