Ventricular Tachycardia Clinical Trial
Official title:
Efficacy and Safety of Multisite Cardiac Resynchronization Therapy - a Prospective Single Center Study in Selected Patient Population
Cardiac resynchronization therapy (CRT) is a proven therapy in patients with severe left
ventricular (LV) dysfunction with ejection fraction (EF)<35%., moderate to severe congestive
heart failure and wide QRS in ECG. Positive response presents as improvement in quality of
life, decrease in congestive hrat failure symptoms and signs, improvements in
echocardiographic measurements and longer survival. About 30% of the patients do not respond
to this treatment.
A decrease in clinical response to CRT is expected in patients with those predictors:
advanced age, male, ischemic etiology of cardiomyopathy, Non-LBBB pattern in ECG, lack of
mechanical dyssynchrony, large scar in LV, congestive heart failure stage IV, and non-cardiac
co-morbidities (lung disease, pulmonary hypertension, renal failure and diabetes).
There are few solutions to increase the rate of clinical response to CRT, for example:
endocardial pacing of LV or pacing a few simultaneous sites on LV. A study that investigated
a method of simultaneous pacing on LV of patients with congestive heart failure and LBBB with
QRS>150ms has shown major improvement of cardiac contraction (increased dP/dtmax) compared to
a single pacing site over a postero-basal or lateral wall site).
Implantation of pacemaker leads- one in right ventricle (RV) and two over LV, i.e. multisite
cardiac resynchronization therapy (MSCRT), has a few potential advantages, compared to
conventional CRT.
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