Cardiac Resynchronization Therapy in Heart Failure: Rationale, Results, Indications, Limits and Perspectives
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Abstract
Heart Failure is the result of heterogeneous structural heart diseases, especially ischemic disease, and is becoming increasingly common in all Western countries.
Many patients continue to be symptomatic in spite of progress in pharmacological therapy, and the risk of mortality remains high in the most advanced functional classes. Cardiac resynchronization therapy can be used as a therapeutic strategy for alleviating symptoms and reducing mortality in selected patients with heart failure.
Cardiac resynchronization therapy provides both immediate and medium/long-term results. The immediate results are the reduced QRS duration, the synchrony restoration between the ventricles and between the lateral and septal walls of the left ventricle, the reduced mitral regurgitation and the increased stroke volume. In the medium/long term, left ventricular reverse remodeling occurs and left ventricular ejection fraction is increased.
Several trials have documented both increased functional capacity and improvements in quality of life and New York Heart Association class. Moreover, cardiac resynchronization therapy has been seen to reduce HF hospitalizations and mortality and the total number of days of hospitalization.
In order to reduce the percentage of non-responders to cardiac resynchronization therapy, it is necessary to optimize the prognostic stratification of candidates for implantation through multi-parameter evaluations and to ensure correct device programming with periodic updates which are widely recommended but not so often performed.
Whether indications should be extended will need to be evaluated in view of the known complications mainly associated with lead implantation.
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Nieminen MS, Harjola VP (2005) Definition and epidemiology of acute heart failure syndromes. Am J Cardiol 96: 5G-10G.
Massie BM, Packer M (1990) Congestive heart failure: current controversies and future prospects. Am J Cardiol 66: 429-430.
Heidenreich PA, Albert NM, Allen LA, Bluemke DA, Butler J, et al. (2013) Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ Heart Fail 6: 606-619.
Anter E, Jessup M, Callans DJ (2009) Atrial fibrillation and heart failure: treatment considerations for a dual epidemic. Circulation 119: 2516-2525.
Jessup M, Brozena S (2003) Heart failure. N Engl J Med 348: 2007-2018.
Metra M, Ponikowski P, Dickstein K, McMurray JJ, Gavazzi A, et al. (2007) Advanced chronic heart failure: A position statement from the Study Group on Advanced Heart Failure of the Heart Failure Association of the European Society of Cardiology. Eur J Heart Fail 9: 684-694.
Gottipaty VK, Krelis SP, Lu F, Spencer EP, Shusterman V, et al. (1999) University of Pittsburgh, Pittsburgh PA, USA. The Resting Electrocardiogram Provides a Sensitive and Inexpensive Marker of Prognosis in Patients with Chronic Congestive Heart Failure. J Am Coll Cardiol 33:145A [Abstr. 847-4].
Blanc JJ, Etienne Y, Gilard M, Mansourati J, Munier S, et al. (1997) Evaluation of different ventricular pacing sites in patients with severe heart failure: results of an acute hemodynamic study. Circulation 96: 3273-3277.
Kass DA, Chen CH, Curry C, Talbot M, Berger R, et al. (1999) Improved left ventricular mechanics from acute VDD pacing in patients with dilated cardiomyopathy and ventricular conduction delay. Circulation 99: 1567-1573.
Russell K, Smiseth OA, Gjesdal O, Qvigstad E, Norseng PA, et al. (2011) Mechanism of prolonged electromechanical delay in late activated myocardium during left bundle branch block. Am J Physiol Heart Circ Physiol 301: H2334-H2343.
Lund LH, Jurga J, Edner M, Benson L, Dahlström U, et al. (2013) Prevalence, correlates, and prognostic significance of QRS prolongation in heart failure with reduced and preserved ejection fraction. Eur Heart J 34: 529-539.
Clark AL, Goode K, Cleland JG (2008) The prevalence and incidence of left bundle branch block in ambulant patients with chronic heart failure. Eur J Heart Fail 10: 696-702.
Kyriacou A, Pabari PA, Mayet J, Peters NS, Davies DW, et al. (2014) Cardiac resynchronization therapy and AV optimization increase myocardial oxygen consumption, but increase cardiac function more than proportionally. Int J Cardiol 171: 144-152.
Freeman JV, Masoudi FA (2013) Effectiveness of implantable cardioverter defibrillators and cardiac resynchronization therapy in heart failure. Heart Fail Clin 9: 59-77.
Gras D, Leclercq C, Tang AS, Bucknall C, Luttikhuis HO, et al. (2002) Cardiac resynchronization therapy in advanced heart failure the multicenter InSync clinical study. Eur J Heart Fail 4: 311-320.
Kühlkamp V (2002) Initial experience with an implantable cardioverter-defibrillator incorporating cardiac resynchronization therapy. J Am Coll Cardiol 39: 790-797.
Abraham WT, Fisher WG, Smith AL, Delurgio DB, Leon AR, et al. (2002) Cardiac resynchronization in chronic heart failure. N Engl J Med 346: 1845-1853.
Young JB, Abraham WT, Smith AL, Leon AR, Lieberman R, et al. (2003) Combined cardiac resynchronization and implantable cardioversion defibrillation in advanced chronic heart failure: the MIRACLE ICD Trial. JAMA 289: 2685-2694.
Cazeau S, Leclercq C, Lavergne T, Walker S, Varma C, et al. (2001) Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med 344: 873-880.
Auricchio A, Stellbrink C, Sack S, Block M, Vogt J, et al. (2002) Long-term clinical effect of hemodynamically optimized cardiac resynchronization therapy in patients with heart failure and ventricular conduction delay. JAm Coll Cardiol 39: 2026-2033.
Auricchio A, Stellbrink C, Butter C, Sack S, Vogt J, et al. (2003) Clinical efficacy of cardiac resynchronization therapy using left ventricular pacing in heart failure patients stratified by severity of ventricular conduction delay. J Am Coll Cardiol 42: 2109-2116.
Bristow MR, Saxon LA, Boehmer J, Krueger S, Kass DA, et al. (2004) Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure. N Engl J Med 350: 2140-2150.
Cleland JG, Daubert JC, Erdmann E, Freemantle N, Gras D, et al. (2005) The effect of cardiac resynchronization on morbidity and mortality in heart failure. N Engl J Med 352: 1539-1549.
(1999) The Cardiac Insufficiency Bisoprolol Study II (CIBIS-II): a randomised trial. Lancet 353: 9-13.
Packer M, Fowler MB, Roecker EB, Coats AJ, Katus HA, et al. (2002) Effect of carvedilol on the morbidity of patients with severe chronic heart failure: results of the carvedilol prospective randomized cumulative survival (COPERNICUS) study. Circulation 106: 2194-2199.
(1992) Effect of enalapril on mortality and the development of heart failure in asymptomatic patients with reduced left ventricular ejection fractions. The SOLVD Investigattors. N Engl J Med 327: 685-691.
Kjekshus J, Swedberg K, Snapinn S (1992) Effects of enalapril on long-term mortality in severe congestive heart failure. CONSENSUS Trial Group. Am J Cardiol 69: 103-107.
(1996) Effectiveness of spironolactone added to an angiotensin-converting enzyme inhibitor and a loop diuretic for severe chronic congestive heart failure (the Randomized Aldactone Evaluation Study [RALES]). Am J Cardiol 78: 902-907.
Linde C, Abraham WT, Gold MR, St John Sutton M, Ghio S, et al. (2008) 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 52: 1834-1843.
Moss AJ, Hall WJ, Cannom DS, Klein H, Brown MW, et al. (2009) Cardiac-resynchronization therapy for the prevention of heart-failure events. N Engl J Med 361: 1329-1338.
Tang AS, Wells GA, Talajic M, Arnold MO, Sheldon R, et al. (2010) Cardiac-resynchronization therapy for mild-to-moderate heart failure. N Engl J Med 363: 2385-1395.
Cleland JG, Abraham WT, Linde C, Gold MR, Young JB, et al. (2013) An individual patient meta-analysis of five randomized trials assessing the effects of cardiac resynchronization therapy on morbidity and mortality in patients with symptomatic heart failure. Eur Heart J 34: 3547-3556.
Tracy CM, Epstein AE, Darbar D, Dimarco JP, Dunbar SB, et al. (2012) 2012 ACCF/AHA/HRS focused update of the 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. J Am Coll Cardiol 60: 1297-1313.
Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, Boriani G, et al. (2013) 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy: the Task Force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Eur Heart J 34: 2281-2329.
Linde C, Ellenbogen K, McAlister FA (2012) Cardiac resynchronization therapy (CRT): clinical trials, guidelines, and target populations. Heart Rhythm 9: S3-S13.
Mullens W, Grimm RA, Verga T, Dresing T, Starling RC, et al. (2009) Insights from a cardiac resynchronization optimization clinic as part of a heart failure disease management program. J Am Coll Cardiol 53: 765-773.
Ansalone G, Giannantoni P, Ricci R, Trambaiolo P, Fedele F, et al. (2002) Doppler myocardial imaging to evaluate the effectiveness of pacing sites in patients receiving biventricular pacing. J Am Coll Cardiol 39: 489-499.
Ypenburg C, van Bommel RJ, Delgado V, Mollema SA, Bleeker GB, et al. (2008) Optimal left ventricular lead position predicts reverse remodeling and survival after cardiac resynchronization therapy. J Am Coll Cardiol 52: 1402-1409.
Ypenburg C, Roes SD, Bleeker GB, Kaandorp TA, de Roos A, et al. (2007) Effect of total scar burden on contrast-enhanced magnetic resonance imaging on response to cardiac resynchronization therapy. Am J Cardiol 99: 657-660.
Bleeker GB, Kaandorp TA, Lamb HJ, Boersma E, Steendijk P, et al. (2006) Effect of posterolateral scar tissue on clinical and echocardiographic improvement after cardiac resynchronization therapy. Circulation 113: 969-976.
Ypenburg C, Sieders A, Bleeker GB, Holman ER, van der Wall EE, et al. (2007) Myocardial contractile reserve predicts improvement in left ventricular function after cardiac resynchronization therapy. Am Heart J 154: 1160-1165.
Ypenburg C, Schalij MJ, Bleeker GB, Steendijk P, Boersma E, et al. (2006) Extent of viability to predict response to cardiac resynchronization therapy in ischemic heart failure patients. J Nucl Med 47: 1565-1570.
Ypenburg C, Schalij MJ, Bleeker GB, Steendijk P, Boersma E, et al. (2007) Impact of viability and scar tissue on response to cardiac resynchronization therapy in ischaemic heart failure patients. Eur Heart J 28: 33-41.
Auricchio A, Prinzen FW (2011) Non-responders to cardiac resynchronization therapy: the magnitude of the problem and the issues. Circ J 75: 521-527.
Burri H, Sunthorn H, Shah D, Lerch R (2006) Optimization of device programming for cardiac resynchronization therapy. Pacing Clin Electrophysiol 29: 1416-1425.
Lazarus A (2007) Remote, wireless, ambulatory monitoring of implantable pacemakers, cardioverter defibrillators, and cardiac resynchronization therapy systems: analysis of a worldwide database. Pacing Clin Electrophysiol 30 Suppl 1: S2-S12.
Saxon LA, Hayes DL, Gilliam FR, Heidenreich PA, Day J, et al. (2010) Long-term outcome after ICD and CRT implantation and influence of remote device follow-up: the ALTITUDE survival study. Circulation 122: 2359-2367.
Dickstein K, Bogale N, Priori S, Auricchio A, Cleland JG, et al. (2009) The European cardiac resynchronization therapy survey. Eur Heart J 30: 2450-2460.
Biffi M, Moschini C, Bertini M, Saporito D, Ziacchi M, et al. (2009) Phrenic stimulation: a challenge for cardiac resynchronization therapy. Circ Arrhythm Electrophysiol 2: 402-410.
Pappone C, Ćalović Ž, Vicedomini G, Cuko A, McSpadden LC, et al. (2014) Multipoint left ventricular pacing improves acute hemodynamic response assessed with pressure-volume loops in cardiac resynchronization therapy patients. Heart Rhythm 11: 394-401.
Padeletti L, Colella A, Michelucci A, Pieragnoli P, Ricciardi G, et al. (2008) Dual-site left ventricular cardiac resynchronization therapy. Am J Cardiol 102: 1687-1692.
Shetty AK, Sohal M, Chen Z, Ginks MR, Bostock J, et al. (2014) A comparison of left ventricular endocardial, multisite, and multipolar epicardial cardiac resynchronization: an acute haemodynamic and electroanatomical study. Europace 16: 873-879.
van Deursen C, van Geldorp IE, Rademakers LM, van Hunnik A, Kuiper M, et al. (2009) Left ventricular endocardial pacing improves resynchronization therapy in canine left bundle-branch hearts. Circ Arrhythm Electrophysiol 2: 580-587.
Ginks MR, Lambiase PD, Duckett SG, Bostock J, Chinchapatnam P, et al. (2011) A simultaneous X-Ray/MRI and noncontact mapping study of the acute hemodynamic effect of left ventricular endocardial and epicardial cardiac resynchronization therapy in humans. Circ Heart Fail 4: 170-179.
Padeletti L, Pieragnoli P, Ricciardi G, Perrotta L, Grifoni G, et al. (2012) Acute hemodynamic effect of left ventricular endocardial pacing in cardiac resynchronization therapy: assessment by pressure-volume loops. Circ Arrhythm Electrophysiol 5: 460-467.
Zareba W, Klein H, Cygankiewicz I, Hall WJ, McNitt S, et al. (2011) Effectiveness of Cardiac Resynchronization Therapy by QRS Morphology in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT). Circulation 123: 1061-1072.
Sipahi I, Carrigan TP, Rowland DY, Stambler BS, Fang JC (2011) Impact of QRS duration on clinical event reduction with cardiac resynchronization therapy: meta-analysis of randomized controlled trials. Arch Intern Med 171: 1454-1462.
Yusuf J, Agrawal DK, Mukhopadhyay S, Mehta V, Trehan V, et al. (2013) Fragmented narrow QRS complex: predictor of left ventricular dyssynchrony in non-ischemic dilated cardiomyopathy. Indian Heart J 65: 172-179.
Tigen K, Karaahmet T, Gurel E, Cevik C, Nugent K, et al. (2009) The utility of fragmented QRS complexes to predict significant intraventricular dyssynchrony in nonischemic dilated cardiomyopathy patients with a narrow QRS interval. Can J Cardiol 25: 517-522.
Celikyurt U, Agacdiken A, Sahin T, Al N, Vural A, et al. (2012) Relationship between fragmented QRS and response to cardiac resynchronization therapy. J Interv Card Electrophysiol 35: 337-342.
Celikyurt U, Agacdiken A, Sahin T, Al N, Kozdag G, et al. (2013) Number of leads with fragmented QRS predicts response to cardiac resynchronization therapy. Clin Cardiol 36: 36-39.
Stabile G, Bertaglia E, Botto G, Isola F, Mascioli G, et al. (2013) Cardiac Resynchronization Therapy MOdular REgistry: ECG and Rx predictors of response to cardiac resynchronization therapy (NCT01573091). J Cardiovasc Med (Hagerstown) 14: 886-893.
Chung ES, Leon AR, Tavazzi L, Sun JP, Nihoyannopoulos P, et al. (2008) Results of the Predictors of Response to CRT (PROSPECT) trial. Circulation 117: 2608-2616.
Beshai JF, Grimm RA, Nagueh SF, Baker JH 2nd, Beau SL, et al. (2007) Cardiac-resynchronization therapy in heart failure with narrow QRS complexes. N Engl J Med 357: 2461-2471.
Thibault B, Harel F, Ducharme A, White M, Ellenbogen KA, et al. (2013) Cardiac resynchronization therapy in patients with heart failure and a QRS complex <120 milliseconds: the Evaluation of Resynchronization Therapy for Heart Failure (LESSER-EARTH) trial. Circulation 127: 873-881.
Ruschitzka F, Abraham WT, Singh JP, Bax JJ, Borer JS, et al. (2013) Cardiac-resynchronization therapy in heart failure with a narrow QRS complex. N Engl J Med 369: 1395-1405.
Albertsen AE, Nielsen JC, Poulsen SH, Mortensen PT, Pedersen AK, et al. (2008) Biventricular pacing preserves left ventricular performance in patients with high-grade atrio-ventricular block: a randomized comparison with DDD(R) pacing in 50 consecutive patients. Europace 10: 314-320.
Chan JY, Fang F, Zhang Q, Fung JW, Razali O, et al. (2011) Biventricular pacing is superior to right ventricular pacing in bradycardia patients with preserved systolic function: 2-year results of the PACE trial. Eur Heart J 32: 2533-2540.
Stockburger M, Gómez-Doblas JJ, Lamas G, Alzueta J, Fernández-Lozano I, et al. (2011) Preventing ventricular dysfunction in pacemaker patients without advanced heart failure: results from a multicentre international randomized trial (PREVENT-HF). Eur J Heart Fail 13: 633-641.
Kindermann M, Hennen B, Jung J, Geisel J, Böhm M, et al. (2006) Biventricular versus conventional right ventricular stimulation for patients with standard pacing indication and left ventricular dysfunction: the Homburg Biventricular Pacing Evaluation (HOBIPACE). J Am Coll Cardiol 47: 1927-1937.
Martinelli Filho M, de Siqueira SF, Costa R, Greco OT, Moreira LF, et al. (2010) Conventional versus biventricular pacing in heart failure and bradyarrhythmia: the COMBAT study. J Card Fail 16: 293-300.
Curtis AB, Worley SJ, Adamson PB, Chung ES, Niazi I, et al. (2013) Biventricular pacing for atrioventricular block and systolic dysfunction. N Engl J Med 368: 1585-1593.
Mazza A, Bendini MG, Leggio M, Riva U, Ciardiello C, et al. (2013) Incidence and predictors of heart failure hospitalization and death in permanent pacemaker patients: a single-centre experience over medium-term follow-up. Europace 15: 1267-1272.
De Sisti A, Márquez MF, Tonet J, Bonny A, Frank R, et al. (2012) Adverse effects of long-term right ventricular apical pacing and identification of patients at risk of atrial fibrillation and heart failure. Pacing Clin Electrophysiol 35: 1035-1043.
Poole JE, Gleva MJ, Mela T, Chung MK, Uslan DZ, et al. (2010) Complication rates associated with pacemaker or implantable cardioverter-defibrillator generator replacements and upgrade procedures: results from the REPLACE registry. Circulation 122: 1553-1561.