Cardiac Resynchronization Therapy in Patients with advanced | ||
| Mustansiriya Medical Journal | ||
| Article 1, Volume 13, Issue 2, December 2014, Pages 28-35 | ||
| Author | ||
| Arshad Fuad | ||
| Abstract | ||
| Background: Evidence suggests that Cardiac Resynchronization Therapy (CRT) is useful in patients with advanced heart failure (HF) & wide QRS complexes despite optimal medical therapy Objective: To demonstrate the beneficial effect of CRT in improving the hemodynamic profile of patients with advanced HF despite optimal medical therapy. Methods: This prospective study enrolled 22 patients with advanced heart failure (HF) who were selected from those patients who attend Ibn Al‐Bitar center for cardiac surgery during the period from September 2010 to April 2011. All patients were subjected to thorough history taking and physical examination and have been investigated to assess their eligibility to CRT.ECG and Echocardiography {assessing LV systolic & diastolic functions, septal to posterior wall motion delay (SPWMD), left ventricular volumes, left ventricle ejection fraction (LVEF) (by biplane Simpson’s method) and mitral regurgitation (MR)} had been done to all patients before and 1 day after CRT device implantation. Tei index calculated before and after CRT, comparing responders and non‐responders. Results: Sixteen patients (72.7%) are matching the definition of the responders. The responders have a decrease in QRS width (by 14.63%), LV end‐diastolic diameter (by 6.35%), Tei index (by 14.85%), LV end‐systolic volume (16.61%), and SPWMD (by 41.72%) with increase in EF (by 22.86%) in comparison to the non‐responder.Also responders patients had higher mean initial Tei index (1.040) in comparison to non‐responders whose their mean initial Tei index was (0.9616). Conclusions: CRT has been shown to improve the functional status in a majority of patients with drug –refractory Heart failure (ischemic, or dilated cardiomyopathy), and Wide QRS complex & resulted in decrease rate of hospitalization in responders. | ||
| Keywords | ||
| Resynchronization; Therapy Heart Failure; wide QRS complex | ||
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