SpringerLink
Log in

Pacing and Cardiac Resynchronization

  • Chapter
  • First Online:
Electrical Diseases of the Heart

  • 2112 Accesses

Abstract

Pacemaker therapy for antibradycardia support and cardiac resynchronization for amelioration of congestive heart failure have evolved technologically and application these therapies in different patient populations has been studied extensively. This chapter reviews new indications for cardiac resynchronization therapy (CRT), and application of CRT in patients with atrial fibrillation and patients with right bundle branch block. Strategies to improve response to CRT by echocardiographic screening of candidates as well as schemes to improve response to CRT by alteration of atrioventricular and interventricular timing sequences as well as newer lead and pulse generator technology are reviewed. New information on the potentially deleterious effect of right ventricular pacing and strategies to minimize this are reviewed.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Chapter
USD 29.95
Price excludes VAT (Canada)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (Canada)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 139.99
Price excludes VAT (Canada)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info
Hardcover Book
USD 199.99
Price excludes VAT (Canada)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free ship** worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Moss AJ, Hall WJ, Cannom DS, et al. Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med. 2009;361(14):1329–38.

    Article  PubMed  Google Scholar 

  2. Tang AS, Wells GA, Talajic M, et al. Cardiac-resynchronization therapy for mild-to-moderate heart failure. N Engl J Med. 2010;363(25):2385–95.

    Article  PubMed  CAS  Google Scholar 

  3. Linde C, Abraham WT, Gold MR, St John Sutton M, Ghio S, Daubert C. Randomized trial of cardiac resynchronization in mildly symptomatic heart failure patients and in asymptomatic patients with left ventricular dysfunction and previous heart failure symptoms. J Am Coll Cardiol. 2008;52(23):1834–43.

    Article  PubMed  Google Scholar 

  4. Zareba W. Comparison of clinical trials evaluating cardiac resynchronization therapy in mild to moderate heart failure. Cardiol J. 2010;17(6):543–8.

    PubMed  Google Scholar 

  5. Centers for Medicare and Medicaid Services. http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm234646.htm. Accessed 10 Aug 2012.

  6. Dickstein K, Vardas PE, Auricchio A, et al. 2010 Focused update of ESC guidelines on device therapy in heart failure: an update of the 2008 ESC guidelines for the diagnosis and treatment of acute and chronic heart failure and the 2007 ESC guidelines for cardiac and resynchronization therapy. Developed with the special contribution of the Heart Failure Association and the European Heart Rhythm Association. Eur J Heart Fail. 2010;12(11):1143–53.

    Article  PubMed  Google Scholar 

  7. Maisel WH, Stevenson LW. Atrial fibrillation in heart failure: epidemiology, pathophysiology, and rationale for therapy. Am J Cardiol. 2003;91(6A):2D–8.

    Article  PubMed  Google Scholar 

  8. Tolosana JM, Hernandez Madrid A, Brugada J, et al. Comparison of benefits and mortality in cardiac resynchronization therapy in patients with atrial fibrillation versus patients in sinus rhythm (Results of the Spanish Atrial Fibrillation and Resynchronization [SPARE] Study). Am J Cardiol. 2008;102(4):444–9.

    Article  PubMed  Google Scholar 

  9. Leclercq C, Walker S, Linde C, et al. Comparative effects of permanent biventricular and right-univentricular pacing in heart failure patients with chronic atrial fibrillation. Eur Heart J. 2002;23(22):1780–7.

    Article  PubMed  CAS  Google Scholar 

  10. Wilton SB, Leung AA, Ghali WA, Faris P, Exner DV. Outcomes of cardiac resynchronization therapy in patients with versus those without atrial fibrillation: a systematic review and meta-analysis. Heart Rhythm. 2011;8(7):1088–94.

    Article  PubMed  Google Scholar 

  11. Upadhyay GA, Choudhry NK, Auricchio A, Ruskin J, Singh JP. Cardiac resynchronization in patients with atrial fibrillation: a meta-analysis of prospective cohort studies. J Am Coll Cardiol. 2008;52(15):1239–46.

    Article  PubMed  Google Scholar 

  12. Kamath GS, Cotiga D, Koneru JN, et al. The utility of 12-lead Holter monitoring in patients with permanent atrial fibrillation for the identification of nonresponders after cardiac resynchronization therapy. J Am Coll Cardiol. 2009;53(12):1050–5.

    Article  PubMed  Google Scholar 

  13. Gasparini M, Auricchio A, Regoli F, et al. Four-year efficacy of cardiac resynchronization therapy on exercise tolerance and disease progression: the importance of performing atrioventricular junction ablation in patients with atrial fibrillation. J Am Coll Cardiol. 2006;48(4):734–43.

    Article  PubMed  Google Scholar 

  14. Hsu LF, Jais P, Sanders P, et al. Catheter ablation for atrial fibrillation in congestive heart failure. N Engl J Med. 2004;351(23):2373–83.

    Article  PubMed  CAS  Google Scholar 

  15. Sweeney MO. Wood shop, Sun Tzu, and patient selection for cardiac resynchronization therapy. Heart Rhythm. 2011;8(7):1095–8.

    Article  PubMed  Google Scholar 

  16. Zareba W, Klein H, Cygankiewicz I, et al. Effectiveness of cardiac resynchronization therapy by QRS morphology in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT). Circulation. 2011;123(10):1061–72.

    Article  PubMed  Google Scholar 

  17. Wokhlu A, Rea RF, Asirvatham SJ, et al. Upgrade and de novo cardiac resynchronization therapy: impact of paced or intrinsic QRS morphology on outcomes and survival. Heart Rhythm. 2009;6(10):1439–47.

    Article  PubMed  Google Scholar 

  18. Chung ES, Leon AR, Tavazzi L, et al. Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation. 2008;117(20):2608–16.

    Article  PubMed  Google Scholar 

  19. Miyazaki C, Redfield MM, Powell BD, et al. Dyssynchrony indices to predict response to cardiac resynchronization therapy: a comprehensive prospective single-center study. Circ Heart Fail. 2010;3(5):565–73.

    Article  PubMed  Google Scholar 

  20. Taylor AJ, Elsik M, Broughton A, et al. Combined dyssynchrony and scar imaging with cardiac magnetic resonance imaging predicts clinical response and long-term prognosis following cardiac resynchronization therapy. Europace. 2010;12(5):708–13.

    Article  PubMed  Google Scholar 

  21. Auricchio A, Stellbrink C, Block M, et al. Effect of pacing chamber and atrioventricular delay on acute systolic function of paced patients with congestive heart failure. The Pacing Therapies for Congestive Heart Failure Study Group. The Guidant Congestive Heart Failure Research Group. Circulation. 1999;99(23):2993–3001.

    Article  PubMed  CAS  Google Scholar 

  22. Perego GB, Chianca R, Facchini M, et al. Simultaneous vs. sequential biventricular pacing in dilated cardiomyopathy: an acute hemodynamic study. Eur J Heart Fail. 2003;5(3):305–13.

    Article  PubMed  Google Scholar 

  23. Ellenbogen KA, Gold MR, Meyer TE, et al. Primary results from the SmartDelay determined AV optimization: a comparison to other AV delay methods used in cardiac resynchronization therapy (SMART-AV) trial: a randomized trial comparing empirical, echocardiography-guided, and algorithmic atrioventricular delay programming in cardiac resynchronization therapy. Circulation. 2010;122(25):2660–8.

    Article  PubMed  Google Scholar 

  24. Boriani G, Muller CP, Seidl KH, et al. Randomized comparison of simultaneous biventricular stimulation versus optimized interventricular delay in cardiac resynchronization therapy. The Resyn­chronization for the HemodYnamic Treatment for Heart Failure Management II implantable cardioverter defibrillator (RHYTHM II ICD) study. Am Heart J. 2006;151(5):1050–8.

    Article  PubMed  Google Scholar 

  25. Thibault B, Karst E, Ryu K, Paiement P, Farazi TG. Pacing electrode selection in a quadripolar left heart lead determines presence or absence of phrenic nerve stimulation. Europace. 2010;12(5):751–3.

    Article  PubMed  Google Scholar 

  26. Tse HF, Yu C, Wong KK, et al. Functional abnormalities in patients with permanent right ventricular pacing: the effect of sites of electrical stimulation. J Am Coll Cardiol. 2002;40(8):1451–8.

    Article  PubMed  Google Scholar 

  27. Sweeney MO, Bank AJ, Nsah E, et al. Minimizing ventricular pacing to reduce atrial fibrillation in sinus-node disease. N Engl J Med. 2007;357(10):1000–8.

    Article  PubMed  CAS  Google Scholar 

  28. Yu CM, Chan JY, Zhang Q, et al. Biventricular pacing in patients with bradycardia and normal ejection fraction. N Engl J Med. 2009;361(22):2123–34.

    Article  PubMed  Google Scholar 

  29. Sagar S, Shen WK, Asirvatham SJ, et al. Effect of long-term right ventricular pacing in young adults with structurally normal heart. Circulation. 2010;121(15):1698–705.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Internal Medicine, Cardiovascular Diseases, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA

    Robert F. Rea MD

Authors
  1. Robert F. Rea MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Robert F. Rea MD .

Editor information

Editors and Affiliations

  1. , Department of Internal Medicine, UMDNJ-RWJ Medical School, Robert Wood Johnson Pl. 1, New Brunswick, 08903-0019, New Jersey, USA

    Ihor Gussak

  2. , Gordon K. Moe Scholar, Masonic Medical Research Laboratory, Bleecker Street, Utica, 13501-1787, New York, USA

    Charles Antzelevitch

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer-Verlag London

About this chapter

Cite this chapter

Rea, R.F. (2013). Pacing and Cardiac Resynchronization. In: Gussak, I., Antzelevitch, C. (eds) Electrical Diseases of the Heart. Springer, London. https://doi.org/10.1007/978-1-4471-4978-1_41

Download citation

  • DOI: https://doi.org/10.1007/978-1-4471-4978-1_41

  • Published:

  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-4977-4

  • Online ISBN: 978-1-4471-4978-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation