The management of acute ST-segment elevation myocardial infarction (STEMI) has evolved considerably in recent decades. Modern treatment includes STEMI network activation, antithrombotic drugs, and rapid early revascularization (mainly by mechanical reperfusion). Cardioprotective interventions aimed at reducing the extent of myocardial necrosis have been evaluated in basic and clinical research ...

OBJECTIVES We sought to test the postulate that biventricular pacing diminishes the need for appropriate tachycardia therapy. We reviewed the frequency of therapy in patients, serving as their own controls, who were enrolled in the Ventak CHF (congestive heart failure) biventricular pacing study. BACKGROUND It is well established that both acute and chronic CHF contribute to the need for tach...

Resynchronisation of intra- and interventricular conduction delay by biventricular pacing has become a proven therapy for selected heart failure patients. We present a case of biventricular pacing, used with great success, as a 'bail out' for a patient with refractory congestive heart failure following by-pass surgery.

OBJECTIVE To measure ventricular contractile synchrony in patients with dilated cardiomyopathy (DCM) and to evaluate the effects of biventricular pacing on contractile synchrony and ejection fraction. BACKGROUND Dilated cardiomyopathy is characterized by abnormal ventricular activation and contraction. Biventricular pacing may promote a more coordinated ventricular contraction pattern in thes...

In this issue of the Journal, the study by Higgins et al. (1) from the trial of resynchronization therapy provides the opportunity to assess the current status of both the application of biventricular pacing and the construction of trial end points for new therapies in heart failure (HF). The devices used in this trial clearly improved functional capacity in those patients with major functional...

BACKGROUND AV delay optimisation of biventricular pacing devices (cardiac resynchronisation therapy, CRT) is performed in trials and recommended by current guidelines. The Doppler echocardiographic iterative method is the most commonly recommended. Yet whether it can be executed reliably has never been tested formally. METHODS 36 multinational specialists, familiar with using the echocardiogr...

BACKGROUND Heart failure patients with stable angina, acute coronary syndromes and valvular heart disease may benefit from revascularisation and/or valve surgery. However, the mortality rate is increased- 5-30%. Biventricular pacing using temporary epicardial wires after surgery is a potential mechanism to improve cardiac function and clinical endpoints. METHOD/DESIGN A multi-centred, prospec...

Cardiac resynchronization therapy (CRT) over last two decades has transformed the management expectations of diligently selected patients with systolic heart failure. While the true inception of the idea dates back to 1925 when Wiggers showed that surface stimulation of the caninemyocardium reduced themaximal LV pressure derivative (LV dP/dtmax) and lengthened isometric contraction, the observa...

The beneficial use of biventricular pacing is reported in a patient with hypertrophic cardiomyopathy and intraventricular conduction delay. This resulted in improvements in symptomatic status and exercise tolerance that may be related to cardiac resynchronisation. The improvement in symptoms by biventricular pacing in a patient with hypertrophic cardiomyopathy and intraventricular conduction de...