BACKGROUND Response to cardiac resynchronization therapy depends both on dyssynchrony and (regional) contractility. We hypothesized that septal deformation can be used to infer integrated information on dyssynchrony and regional contractility, and thereby predict cardiac resynchronization therapy response. METHODS AND RESULTS In 132 cardiac resynchronization therapy candidates with left bundl...

OBJECTIVES The purpose of this study was to determine the prevalence of systolic and diastolic dyssynchrony in diastolic heart failure (DHF) patients and identify the effects of medical therapy. BACKGROUND The prevalence of systolic and diastolic dyssynchrony in DHF patients is unknown with no data on the effects of medical therapy on dyssynchrony. METHODS Patients presenting with DHF (n = ...

AIMS To assess long-term effects of cardiac resynchronization therapy (CRT) on left ventricular (LV) dyssynchrony and contractile function, by two-dimensional speckle-tracking echocardiography, compared with implantable cardioverter defibrillator (ICD) only in MADIT-CRT. METHODS AND RESULTS We studied 761 patients in New York Heart Association I/II, ejection fraction ≤30%, and QRS ≥130 ms [n ...

Ventricular dyssynchrony is defined as uncoordinated regional myocardial contraction and relaxation and may be either interventricular or intraventricular. Most of the clinical focus has been on left ventricular (LV) intraventricular dyssynchrony, which in principle may have 3 different origins. First, dyssynchrony may have an electric origin as in left bundle-branch block, which causes nonunif...

AIMS The aim of the current study was to evaluate the relationship between the presence of left ventricular (LV) dyssynchrony at baseline and acute vs. late improvement in mitral regurgitation (MR) after cardiac resynchronization therapy (CRT). METHODS AND RESULTS Sixty eight patients consecutive (LV ejection fraction 23 +/- 8%) with at least moderate MR (>or=grade 2+) were included. Echocard...

BACKGROUND Left ventricular (LV) mechanical dyssynchrony induces regional heterogeneity of mechanical load and is an independent predictor of mortality and sudden death in heart failure (HF) patients. We tested whether dyssynchrony also induces localized disparities in the expression of proteins involved with mechanical stress, function, and arrhythmia susceptibility. METHODS AND RESULTS Elev...

Cardiac resynchronization therapy tailored by echocardiographic evaluation of ventricular asynchrony. JACC 2002;40:1615–22. 5. Cazeau S, Bordacher P, Jauvert A et al. Echocardiographic modeling of cardiac dyssynchrony before and during multisite stimulation. PACE 2003;26:1–7. 6. Yu CM, Fung WH, Lin H et al. Predictors of left ventricular reverse remodeling after ischemic cardiomyopathy. Am J Ca...

Right ventricular (RV) pacing has been reported to result in ventricular dyssynchrony, heart failure, and increased mortality. Pacing associated deterioration of left ventricular (LV) systolic function has been termed pacing-induced cardiomyopathy (PICM). While upgrading to biventricular pacing (BiVP) is an effective therapy for PICM, permanent His-bundle pacing (HBP) can be a physiological alt...

Introduction: Cardiac resynchronization therapy (CRT) has proved successful in larger patient populations as an adjunctive therapy for patients with drug-refractory heart failure and ventricular conduction delay. However, individual responsiveness to CRT is not yet highly predictable. Around 30% of patients do not appear to benefit from CRT [1]. This can either be attributed to inappropriate pa...

INTRODUCTION The septal position is an alternative site for cardiac pacing (CP) that is potentially less harmful to cardiac function. METHODS Patients with Chagas disease without heart failure submitted to permanent pacemaker (PP) implantation at the Clinics Hospital of the Triângulo Mineiro Federal University (UFTM), were selected from February 2009 to February 2010. The parameters analyzed ...