Evaluation of Response Rate to Resynchronization Therapy

The Super-Responder

Authors

  • Izaias Marques de Sa Junior
  • Jose Carlos Pachón Mateos
  • Juan Carlos Pachón Mateos
  • Remy Nelson Albornoz Vargas

Keywords:

Cardiac resynchronization therapy, Respondent, Super-responders

Abstract

Cardiac resynchronization therapy (CRT) emerged as a therapeutic modality for patients with cardiac insufficiency (CI) refractory to pharmacological treatment. Over the last 20 years, several clinical studies have sought to establish their benefits in different populations. The review of the results of these studies has shown that in patients with advanced CI (functional class (FC) I, II, III and IV of the New York Heart Association (NYHA) CRT produces consistent improvements in quality of life, FC and exercise capacity, as well as reducing hospitalizations and mortality rates. Up to 70% of patients submitted to CRT evolve as responders. The criteria adopted in the evaluation of the CRT response rate will be elucidated in this article, in which the main objective is to highlight the concept of the CRT super-responder.

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References

Rich MW. Heart failure in the 21st century: a cardiogeriatric syndrome. J Gerontol A. 2001;56(2):88-96.

Krum H, Gilbert RE. Demographics and concomitant disorders in heart failure. Lancet. 2003;362:147-58. https://doi.org/10.1016/S0140-6736(03)13869-X

Bui AL, Horwich TB, Fonarow GC. Epidemiology and risk profile of heart failure. Nat Rev Cardiol. 2011;8(1):30-41. https://doi.org/10.1038/nrcardio.2010.165

Linde C, Ellenbogen K, Mcalister FA. Cardiac resynchronization therapy (CRT): clinical trial, guidelines, and target populations. Heart Rhytm. 2012;8 Suppl:S3-13.

https://doi.org/10.1016/j.hrthm.2012.04.026

Salerno HD, Oliveira JC, Melo CS, Lage JS. Evidências atuais para indicação de cardioversores-desfibriladores implantáveis e ressincronizadores cardíacos. In: Melo CS, editor. Temas de marcapasso. 2a ed. São Paulo: Leitura Médica; 2011. p 515-31.

Bocchi EA, Marcondes-Braga FA, Bacal F, Ferraz AS, Albuquerque D, Rodrigues DA, et al. Atualização da diretriz brasileira de insuficiência cardíaca crônica – 2012. Arq Bras Cardiol. 2012;8 Suppl:S1-33. https://doi.org/10.5935/abc.20120101

McMurray JJV, Adamopoulos S, Anker SD, Auricchio A, Bohm M, Dickstein K, et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur Heart J. 2012;33:1787-847. https://doi.org/10.1093/eurheartj/ehs104

European Society of Cardiology (ESC), European Heart Rhythm Association (EHRA), Brignole M, Auricchio A, Baron-Esquivias G, Bordachar P, et al. 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). Europace. 2013;15(8):1070-118. https://doi.org/10.1093/europace/eut206

Writing Committee Members, Yancy CW, Jessup M, Bozkurt B, Butler J, Casey Junior DE, et al. American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. 2013 ACCF/AHA guideline for the management of heart failure: a report of the American College of Cardiology Foundation/American Heart Association Task Force on practice guidelines. Circulation. 2013;128(16):e240-327. https://doi.org/10.1161/CIR.0b013e31829e877610.

Poole JE, Singh JP, Birgersdotter-Green U. QRS duration or QRS morphology. What really matters in cardiac resynchronization therapy? JACC. 2016;67(9):1104-17.

https://doi.org/10.1016/j.jacc.2015.12.039

Bleeker GB, Kaandorp TA, Lamb HJ, Boersma E, Steendijk P, et al. Effect of posterolateral scar tissue on clinical and echocardiographic improvement after cardiac

resynchronization therapy. Circulation. 2006;113:969-76.

https://doi.org/10.1161/circulationaha.105.543678

Ypenburg C, Roes SD, Bleeker GB, Kaandorp TA, Roos A de, Schalij MJ, et al. Effect of total scar burden on contrast-enhanced magnetic resonance imaging on response to cardiac resynchronization therapy Am J Cardiol. 2007;99(5):657-60. https://doi.org/10.1016/j.amjcard.2006.09.115

Leyva F, Nisam S, Auricchio A. 20 years of cardiac resynchronization therapy. JACC. 2014;64(10):1047-58. https://doi.org/10.1016/j.jacc.2014.06.1178

Lubitz SA, Singh JP. Biventricular pacing: more is better! Eur Heart J. 2015;36(7):407-9. https://doi.org/10.1093/eurheartj/ehu347

Brenyo A, Kutyifa V, Moss AJ, Mathias A, Barsheshet A, Pouleur A-C, et al. Atrioventricular delay programming and the benefit of cardiac resynchronization therapy in MADIT-CRT. Heart Rhyth. 2013;10(8):1101-1248. https://doi.org/10.1016/j.hrthm.2013.04.013

Grines CL, Bashore TM, Boudoulas H, Olson S, Shafer P, Wooley CF. Functional abnormalities in isolated left bundle branch block the effect of interventricular asynchrony. Circulation. 1989;79:845-53.

Angheloiu GO, Saul M, Edelman K, Shah H, Mezu UL, Saba S. Predictors of left ventricular function deterioration in patients with left bundle branch block and ejection

fraction > 50%. Congest Heart Fail. 2013;19(4):E1-4. https://doi.org/10.1111/chf.12028

Blanc JJ, Fatemi M, Bertault V, Baraket F, Etienne Y. Evaluation of left bundle branch block as a reversible cause of non-ischemic dilated cardiomyopathy with severe heart failure. A new concept of left ventricular dyssynchrony-induced cardiomyopathy.

Europace. 2005;7:604-10. https://doi.org/10.1016/j.eupc.2005.06.005

Published

2019-10-16

How to Cite

Sa Junior, I. M. de, Mateos, J. C. P., Mateos, J. C. P. ., & Vargas, R. N. A. (2019). Evaluation of Response Rate to Resynchronization Therapy: The Super-Responder. JOURNAL OF CARDIAC ARRHYTHMIAS, 32(1), 43–48. Retrieved from https://jca.emnuvens.com.br/jca/article/view/14

Issue

Section

Cardiac Pacing

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