Cardiac Resynchronization Therapy: An Established Pacing Therapy for Heart Failure and Mechanical Dyssynchrony

Indications of Cardiac Resynchronization Therapy Based on Clinical Guidelines

Author(s): Concepción Alonso-Martin, Nuria Rivas Gandara, Oscar Alcalde Rodríguez and Angel Moya Mitjans

Pp: 33-37 (5)

DOI: 10.2174/978160805030711101010033

* (Excluding Mailing and Handling)

Abstract

Since the first application of cardiac resynchronization therapy (CRT) in 1994, an important body of information has been delivered from many randomized trials including a large number of patients. Most of these trials have showed strong evidence to support the use of CRT to improve heart failure symptoms, quality of life, left ventricular ejection fraction, exercise capacity and survival. As a result, current guidelines recommend the use of CRT as a Class I indication in patients with NYHA classes III or IV, LVEF less than 35%, QRS duration greater than120 ms, LV end-diastolic diameter > 55 mm and, sinus rhythm. However, a lack of information exists regarding other scenarios such as patients in NYHA classes II, patients with a narrow QRS complex, patients with normal ejection fraction or patients with baseline rhythms other than sinus rhythm such as those in atrial fibrillation or pacing dependent. The following chapter is dedicated to the indications for CRT therapy recommended on current clinical guidelines from the American and European Societies reviewing the clinical evidence supporting these indications.


Keywords: Mechanical dyssynchrony, electrical dyssynchrony, heart failure, ventricular dysfunction, cardiac, resynchronization therapy

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      • 13. app/Models/UserAccess/UserAccess.php:1266
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      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Trial Access" as access_base_text, CASE j.type WHEN 111 THEN true ELSE false END as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_trail` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316440840 and j.to_ip >=316440840 )) and ((j.from_date <= 1739834707 and j.to_date >= 1739834707 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1534) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Subscribed" as access_base_text, false as terms_popup, "S" as content_download_type, null as restricted_user_access_key, null as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_corporate` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316440840 and j.to_ip >=316440840 )) and ((j.from_date <= 1739834707 and j.to_date >= 1739834707 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1534) union (select j.user_access_id,j.volume_id,j.user_id,j.from_ip,j.to_ip,j.type,j.track,"Token Based Access" as access_base_text, false as terms_popup, "R" as content_download_type, j.uc_id as restricted_user_access_key, "v" as restricted_user_access_type, CASE j.track WHEN 0 THEN false ELSE true END as tracksAccessByVolume,"chapter" as access_level, j.chapter_id from `user_access_chapter_token` as `j` inner join `user_access_info` as `info` on `j`.`user_access_id` = `info`.`user_access_id` where ((j.from_ip <= 316440840 and j.to_ip >=316440840 )) and ((j.from_date <= 1739834707 and j.to_date >= 1739834707 and j.perpetual= 0) or (j.from_date is null and j.to_date is null and j.perpetual= 1)) and j.chapter_id = 1534)
      750μsalphaeurekaselec_live_10_06_2022UserAccess.php#1266
      Backtrace
      • 13. app/Models/UserAccess/UserAccess.php:1266
      • 14. app/Http/Controllers/ChapterController.php:1549
      • 15. vendor/laravel/framework/src/Illuminate/Routing/Controller.php:54
      • 16. vendor/laravel/framework/src/Illuminate/Routing/ControllerDispatcher.php:43
      • 17. vendor/laravel/framework/src/Illuminate/Routing/Route.php:260
    • select b.banner_link, b.banner_name, b.banner_script, b.banner_remarks, b.banner_file_name, b.banner_placement, bd.content_type, bd.content_id from `tbl_banner` as `b` inner join `tbl_banner_detail` as `bd` on `bd`.`banner_id` = `b`.`banner_id` inner join `users` as `u` on `u`.`id` = `b`.`updated_by` where `b`.`banner_ebook` = 1 and `bd`.`content_type` = 'B' and `bd`.`content_id` = 901 and `b`.`banner_from_date` <= 1739834707 and `b`.`banner_to_date` >= 1739834707 and `b`.`banner_status` = 'A' order by `b`.`banner_id` desc
      1.47msalphaeurekaselec_live_10_06_2022Banner.php#95
      Bindings
      • 0: 1
      • 1: B
      • 2: 901
      • 3: 1739834707
      • 4: 1739834707
      • 5: A
      Backtrace
      • 13. app/Models/Banner.php:95
      • 14. app/Http/helpers.php:404
      • 17. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 18. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    • select count(*) as aggregate from `uc_cart_products` where cart_id='717c9893b1cc8c7187e54e806270854e'
      200μsalphaeurekaselec_live_10_06_2022Cart.php#271
      Backtrace
      • 15. app/Models/Cart.php:271
      • 16. view::layouts._header:260
      • 18. vendor/laravel/framework/src/Illuminate/Filesystem/Filesystem.php:124
      • 19. vendor/laravel/framework/src/Illuminate/View/Engines/PhpEngine.php:58
      • 20. vendor/laravel/framework/src/Illuminate/View/Engines/CompilerEngine.php:73
    App\Models\Keywords
    6Keywords.php#?
    App\Models\Chapter
    1Chapter.php#?
    App\Models\Ebook
    1Ebook.php#?
        _token
        0kgmOB2oXXrB04mTKIETkVOC8GLQrj9YhCLwGXOZ
        uc_cart_id
        717c9893b1cc8c7187e54e806270854e
        _previous
        array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/1534" ]
        _flash
        array:2 [ "old" => [] "new" => [] ]
        PHPDEBUGBAR_STACK_DATA
        []
        path_info
        /chapter/1534
        status_code
        200
        
        status_text
        OK
        format
        html
        content_type
        text/html; charset=UTF-8
        request_query
        []
        
        request_request
        []
        
        request_headers
        0 of 0
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        request_cookies
        0 of 0
        array:2 [ "wayfindertarget" => null "fpestid" => null ]
        response_headers
        0 of 0
        array:5 [ "content-type" => array:1 [ 0 => "text/html; charset=UTF-8" ] "cache-control" => array:1 [ 0 => "no-cache, private" ] "date" => array:1 [ 0 => "Mon, 17 Feb 2025 23:25:07 GMT" ] "set-cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkZsTURHSStYbGljMU11K2l3VUJkWnc9PSIsInZhbHVlIjoiS2RsNWZDS0F4anQ5ZGF2U2lXZFZhMk94TXBNNjlkQW4rTllpdjB4TEdqS3cySW1OMGQ5Ukw0a2UzdTEwNlFuQXVkWXZyNVkyMW9LQnFlTkJOelBacmR5UkJjY2Q1a0xpZTFFUHpWNXhMN0ZiOWNaRkc3MTBxUkplSkd6MWtObnYiLCJtYWMiOiI5ZWRmOTg1MGEwYTRjYWY4ZWFkNDRmNWUzYTFjZGFhMDA1MTJkNzUzMDY5Y2EwMjU4OWRmODViNjcyMWQ5MWRiIiwidGFnIjoiIn0%3D; expires=Thu, 20 Feb 2025 11:25:07 GMT; Max-Age=216000; path=/; secure; samesite=laxXSRF-TOKEN=eyJpdiI6IkZsTURHSStYbGljMU11K2l3VUJkWnc9PSIsInZhbHVlIjoiS2RsNWZDS0F4anQ5ZGF2U2lXZFZhMk94TXBNNjlkQW4rTllpdjB4TEdqS3cySW1OMGQ5Ukw0a2UzdTEwNlFuQXVkWXZyN" 1 => "alphaeurekaselectnet_session=eyJpdiI6ImwwY1VFV0hhZzdSdlY4N3lkcVJWcUE9PSIsInZhbHVlIjoiKzdhWE13OUZEZVowcWRqSmo0WHNXS1JGQXpKSktCUElEc2JsRmtCeXdDbDdJNEhHaWp4TGVQaDBmYnYxL2FOWTRnSkdIZlRCMWFtdmVCaDlDM0dRM3JHbUpFT0p2Y0NIQnpwNmQ0cTBTcHFCbFRtdE50WWRCNDlobzAwRngzQXIiLCJtYWMiOiI3YWRlNjNhYTNhNjc0ZWM0MDNhNjNhNzk3YThhMTU0OWU3ZjQ1YzIxMDZkNTdmNjc0YThlM2Q3ODBlODQ1MGZkIiwidGFnIjoiIn0%3D; path=/; secure; httponly; samesite=laxalphaeurekaselectnet_session=eyJpdiI6ImwwY1VFV0hhZzdSdlY4N3lkcVJWcUE9PSIsInZhbHVlIjoiKzdhWE13OUZEZVowcWRqSmo0WHNXS1JGQXpKSktCUElEc2JsRmtCeXdDbDdJNEhHaWp4TGVQaDB" ] "Set-Cookie" => array:2 [ 0 => "XSRF-TOKEN=eyJpdiI6IkZsTURHSStYbGljMU11K2l3VUJkWnc9PSIsInZhbHVlIjoiS2RsNWZDS0F4anQ5ZGF2U2lXZFZhMk94TXBNNjlkQW4rTllpdjB4TEdqS3cySW1OMGQ5Ukw0a2UzdTEwNlFuQXVkWXZyNVkyMW9LQnFlTkJOelBacmR5UkJjY2Q1a0xpZTFFUHpWNXhMN0ZiOWNaRkc3MTBxUkplSkd6MWtObnYiLCJtYWMiOiI5ZWRmOTg1MGEwYTRjYWY4ZWFkNDRmNWUzYTFjZGFhMDA1MTJkNzUzMDY5Y2EwMjU4OWRmODViNjcyMWQ5MWRiIiwidGFnIjoiIn0%3D; expires=Thu, 20-Feb-2025 11:25:07 GMT; path=/; secureXSRF-TOKEN=eyJpdiI6IkZsTURHSStYbGljMU11K2l3VUJkWnc9PSIsInZhbHVlIjoiS2RsNWZDS0F4anQ5ZGF2U2lXZFZhMk94TXBNNjlkQW4rTllpdjB4TEdqS3cySW1OMGQ5Ukw0a2UzdTEwNlFuQXVkWXZyN" 1 => "alphaeurekaselectnet_session=eyJpdiI6ImwwY1VFV0hhZzdSdlY4N3lkcVJWcUE9PSIsInZhbHVlIjoiKzdhWE13OUZEZVowcWRqSmo0WHNXS1JGQXpKSktCUElEc2JsRmtCeXdDbDdJNEhHaWp4TGVQaDBmYnYxL2FOWTRnSkdIZlRCMWFtdmVCaDlDM0dRM3JHbUpFT0p2Y0NIQnpwNmQ0cTBTcHFCbFRtdE50WWRCNDlobzAwRngzQXIiLCJtYWMiOiI3YWRlNjNhYTNhNjc0ZWM0MDNhNjNhNzk3YThhMTU0OWU3ZjQ1YzIxMDZkNTdmNjc0YThlM2Q3ODBlODQ1MGZkIiwidGFnIjoiIn0%3D; path=/; secure; httponlyalphaeurekaselectnet_session=eyJpdiI6ImwwY1VFV0hhZzdSdlY4N3lkcVJWcUE9PSIsInZhbHVlIjoiKzdhWE13OUZEZVowcWRqSmo0WHNXS1JGQXpKSktCUElEc2JsRmtCeXdDbDdJNEhHaWp4TGVQaDB" ] ]
        session_attributes
        0 of 0
        array:5 [ "_token" => "0kgmOB2oXXrB04mTKIETkVOC8GLQrj9YhCLwGXOZ" "uc_cart_id" => "717c9893b1cc8c7187e54e806270854e" "_previous" => array:1 [ "url" => "https://alpha.eurekaselect.com/chapter/1534" ] "_flash" => array:2 [ "old" => [] "new" => [] ] "PHPDEBUGBAR_STACK_DATA" => [] ]
        ClearShow all
        Date ↕MethodURLData
        #12025-02-17 23:25:07GET/chapter/1534112198