Cardiac resynchronization therapy – indications, guidelines and future perspective Review article
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Published:
Dec 31, 2018
Keywords:
cardiac resynchronization therapy, CRT, left bundle branch block, heart failure
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Abstract
Chronic heart failure carries a poor prognosis despite a significant progress in therapy made in the last years. A wide QRS complex and left bundle branch block increase the mortality of patients with chronic heart failure. Cardiac resynchronization therapy is a fundamental nonpharmacological treatment for patients with symptomatic heart failure with reduced left ventricular ejection fraction and wide QRS complex. In this article, we present the contemporary indications for cardiac resynchronization therapy and future perspectives.
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Januszkiewicz , Łukasz, Załuska, R., & Grabowski , M. (2018). Cardiac resynchronization therapy – indications, guidelines and future perspective. Medycyna Faktow (J EBM), 11(4(41), 314-319. https://doi.org/10.24292/01.MF.0418.10
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References
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8. Auricchio A., Fantoni C., Regoli F. et al.: Characterization of left ventricular activation in patients with heart failure and left bundle-branch block. Circulation 2004; 109: 1133-1139.
9. Francia P., Balla C., Paneni F. et al.: Left bundle-branch block–pathophysiology, prognosis, and clinical management. Clin. Cardiol. 2007; 30: 110-115.
10. Brignole M., Auricchio A., Baron-Esquivias G. et al.: 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur. Heart J. 2013; 34: 2281-2329.
11. Ponikowski P., Voors A.A., Anker S.D. et al.: 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Heart J. 2016; 37: 2129-2200.
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13. Epstein A.E., DiMarco J.P., Ellenbogen K.A. et al.: 2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCF/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. J. Am. Coll. Cardiol. 2013; 61: e6-75.
14. Strauss D.G., Selvester R.H., Wagner G.S.: Defining left bundle branch block in the era of cardiac resynchronization therapy. Am. J. Cardiol. 2011; 107: 927-934.
15. Willems J.L., Robles de Medina E.O., Bernard E.O. et al.: Criteria for interventricular conduction disturbances and preexcitation. World Health Organizational/International Society and Federation for Cardiology Task Force Ad Hoc. J. Am. Coll. Cardiol. 1985; 5: 1261-1275.
16. Normand C., Linde C., Singh J., Dickstein K.: Indications for Cardiac Resynchronization Therapy. A Comparison of the Major International Guidelines. JACC Heart Fail. 2018; 6: 308-316.
17. Ruschitzka F., Abraham W.T., Singh J.P. et al.: Cardiac resynchronization therapy in heart failure with a narrow QRS complex. N. Engl. J. Med. 2013; 369: 1395-1405.
18. Brugada J., Delnoy P.P., Brachmann J. et al.: Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial. Eur. Heart J. 2017; 38: 730-738.
19. Khidir M.J.H., Delgado V., Marsan N.A. et al.: QRS duration versus morphology and survival after cardiac resynchronization therapy. ESC Heart Fail. 2017; 4: 23-30.
20. Cleland J.G., Abraham W.T., Linde C. et al.: 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. 2013; 34: 3547-3556.
21. Poole J.E., Singh J.P., Birgersdotter-Green U.: QRS Duration or QRS Morphology: What Really Matters in Cardiac Resynchronization Therapy? J. Am. Coll. Cardiol. 2016; 67: 1104-1117.
22. Vancura V., Wichterle D., Ulc I. et al.: The variability of automated QRS duration measurement. Europace 2017; 19: 636-643.
23. Januszkiewicz Ł., Vegh E., Borgquist R. et al.: Prognostic implication of baseline PR interval in cardiac resynchronization therapy recipients. Heart Rhythm 2015; 12: 2256-2262.
24. Maass A.H., Vernooy K., Wijers S.C. et al.: Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study. Europace 2018; 20: e1-e10.
25. Tereshchenko L.G., Cheng A., Park J. et al.: Novel measure of electrical dyssynchrony predicts response in cardiac resynchronization therapy: Results from the SMART-AV Trial. Heart Rhythm 2015; 12: 2402-2410.
26. Barsheshet A., Goldenberg I., Moss A.J. et al.: Response to preventive cardiac resynchronization therapy in patients with ischaemic and nonischaemic cardiomyopathy in MADIT-CRT. Eur. Heart J. 2011; 32: 1622-1630.
27. Chatterjee N.A., Roka A., Lubitz S.A. et al.: Reduced appropriate implantable-cardioverter therapy after cardiac resynchronization therapy-induced left ventricular function recovery: a meta-analysis and systematic review. Eur. Heart J. 2015; 36: 2780-2799.
28. Singh J.P., Klein H.U., Huang D.T. et al.: Left ventricular lead position and clinical outcome in the multicenter automatic defibrillator implantation trial-cardiac resynchronization therapy (MADIT-CRT) trial. Circulation 2011; 123: 1159-1166.
29. Kutyifa V., Kosztin A., Klein H.U. et al.: Left Ventricular Lead Location and Long-Term Outcomes in Cardiac Resynchronization Therapy Patients. JACC Clin. Electrophysiol. 2018; 4: 1410-1420.
30. Gold M.R., Yu Y., Singh J.P. et al.: The effect of left ventricular electrical delay on AV optimization for cardiac resynchronization therapy. Heart Rhythm 2013; 10: 988-993.
31. Adelstein E.C., Saba S.: Scar burden by myocardial perfusion imaging predicts echocardiographic response to cardiac resynchronization therapy in ischemic cardiomyopathy. Am. Heart J. 2007; 153: 105-112.
32. Boriani G., Connors S., Kalarus Z. et al.: Cardiac Resynchronization Therapy With a Quadripolar Electrode Lead Decreases Complications at 6 Months: Results of the MORE-CRT Randomized Trial. JACC Clin. Electrophysiol. 2016; 2: 212-220.
33. Forleo G.B., Santini L., Giammaria M. et al.: Multipoint pacing via a quadripolar left-ventricular lead: preliminary results from the Italian registry on multipoint left-ventricular pacing in cardiac resynchronization therapy (IRON-MPP). Europace 2017; 19: 1170-1177.
34. Mazurek M., Jędrzejczyk-Patej E., Lenarczyk R. et al.: Do we need to monitor the percentage of biventricular pacing day by day? Int. J. Cardiol. 2016; 221: 81-89.
35. Daubert C., Behar N., Martins R.P. et al.: Avoiding non-responders to cardiac resynchronization therapy: a practical guide. Eur. Heart J. 2017; 38: 1463-1472.
36. Birnie D., Lemke B., Aonuma K. et al.: Clinical outcomes with synchronization left ventricular pacing: analysis of the adaptive CRT trial. Heart Rhythm 2013; 10: 1368-1374.
37. Altman R.K., Parks K.A., Schlett C.L. et al.: Multidisciplinary care of patients receiving cardiac resynchronization therapy is associated with improved clinical outcomes. Eur. Heart J. 2012; 33: 2181-2188.
38. Biffi M., Defaye P., Jais P. et al.: Benefits of left ventricular endocardial pacing comparing failed implants and prior non-responders to conventional cardiac resynchronization therapy: A subanalysis from the ALSYNC study. Int. J. Cardiol. 2018; 259: 88-93.
39. Reddy V.Y., Miller M.A., Neuzil P. et al.: Cardiac Resynchronization Therapy With Wireless Left Ventricular Endocardial Pacing: The SELECT-LV Study. J. Am. Coll. Cardiol. 2017; 69: 2119-2129.
40. Mafi-Rad M., Luermans J.G., Blaauw Y. et al.: Feasibility and Acute Hemodynamic Effect of Left Ventricular Septal Pacing by Transvenous Approach Through the Interventricular Septum. Circ. Arrhythm. Electrophysiol. 2016; 9: e003344.
41. Sharma P.S., Dandamudi G., Herweg B. et al.: Permanent His-bundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy: A multicenter experience. Heart Rhythm 2018; 15: 413-420.
42. Merkely B., Kosztin A., Roka A. et al.: Rationale and design of the BUDAPEST-CRT Upgrade Study: a prospective, randomized, multicentre clinical trial. Europace 2017; 19: 1549-1555.
43. ClinicalTrails.gov. CRT Implant Strategy Using the Longest Electrical Delay for Non-left Bundle Branch Block Patients (ENHANCE CRT). Dostęp 25.11.2018 r.
2. Cei F., Fonseca C., Mota T. et al.; EPICA Investigators: Prevalence of chronic heart failure in Southwestern Europe: the EPICA study. Eur. J. Heart Fail. 2002; 4: 531-539.
3. Heidenreuch P.A., Albert N.M., Allen L.A. et al.: Forecasting the impact of heart failure in the United States: a policy statement from the American Heart Association. Circ. Heart Fail. 2013; 6: 606-619.
4. Crespo-Leiro M.G., Anker S.D., Maggioni A.P. et al.: European Society of Cardiology Heart Failure Long-Term Registry (ESC-HF-LT): 1-year follow-up outcomes and differences across regions. Eur. J. Heart Fail. 2016; 18: 613-625.
5. Kashani A., Barold S.S.: Significance of QRS Complex Duration in Patients With Heart Failure. J. Am. Coll. Cardiol. 2005; 46: 2183-2192.
6. Clark A.L., Goode K., Cleland J.G.F.: The prevalence and incidence of left bundle branch block in ambulant patients with chronic heart failure. Eur. J. Heart Fail. 2008; 10: 696-702.
7. Neeland I.J., Kontos M.C., de Lemos J.A.: Evolving considerations in the management of patients with left bundle branch block and suspected myocardial infarction. J. Am. Coll. Cardiol. 2012; 60: 96-105.
8. Auricchio A., Fantoni C., Regoli F. et al.: Characterization of left ventricular activation in patients with heart failure and left bundle-branch block. Circulation 2004; 109: 1133-1139.
9. Francia P., Balla C., Paneni F. et al.: Left bundle-branch block–pathophysiology, prognosis, and clinical management. Clin. Cardiol. 2007; 30: 110-115.
10. Brignole M., Auricchio A., Baron-Esquivias G. et al.: 2013 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy. Eur. Heart J. 2013; 34: 2281-2329.
11. Ponikowski P., Voors A.A., Anker S.D. et al.: 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure. Eur. Heart J. 2016; 37: 2129-2200.
12. Kusumoto F.M., Schoenfeld M.H., Barrett C. et al.: 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay. Heart Rhythm 2018. DOI: 10.1016/j.hrthm.2018.10.037.
13. Epstein A.E., DiMarco J.P., Ellenbogen K.A. et al.: 2012 ACCF/AHA/HRS Focused Update Incorporated Into the ACCF/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities. J. Am. Coll. Cardiol. 2013; 61: e6-75.
14. Strauss D.G., Selvester R.H., Wagner G.S.: Defining left bundle branch block in the era of cardiac resynchronization therapy. Am. J. Cardiol. 2011; 107: 927-934.
15. Willems J.L., Robles de Medina E.O., Bernard E.O. et al.: Criteria for interventricular conduction disturbances and preexcitation. World Health Organizational/International Society and Federation for Cardiology Task Force Ad Hoc. J. Am. Coll. Cardiol. 1985; 5: 1261-1275.
16. Normand C., Linde C., Singh J., Dickstein K.: Indications for Cardiac Resynchronization Therapy. A Comparison of the Major International Guidelines. JACC Heart Fail. 2018; 6: 308-316.
17. Ruschitzka F., Abraham W.T., Singh J.P. et al.: Cardiac resynchronization therapy in heart failure with a narrow QRS complex. N. Engl. J. Med. 2013; 369: 1395-1405.
18. Brugada J., Delnoy P.P., Brachmann J. et al.: Contractility sensor-guided optimization of cardiac resynchronization therapy: results from the RESPOND-CRT trial. Eur. Heart J. 2017; 38: 730-738.
19. Khidir M.J.H., Delgado V., Marsan N.A. et al.: QRS duration versus morphology and survival after cardiac resynchronization therapy. ESC Heart Fail. 2017; 4: 23-30.
20. Cleland J.G., Abraham W.T., Linde C. et al.: 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. 2013; 34: 3547-3556.
21. Poole J.E., Singh J.P., Birgersdotter-Green U.: QRS Duration or QRS Morphology: What Really Matters in Cardiac Resynchronization Therapy? J. Am. Coll. Cardiol. 2016; 67: 1104-1117.
22. Vancura V., Wichterle D., Ulc I. et al.: The variability of automated QRS duration measurement. Europace 2017; 19: 636-643.
23. Januszkiewicz Ł., Vegh E., Borgquist R. et al.: Prognostic implication of baseline PR interval in cardiac resynchronization therapy recipients. Heart Rhythm 2015; 12: 2256-2262.
24. Maass A.H., Vernooy K., Wijers S.C. et al.: Refining success of cardiac resynchronization therapy using a simple score predicting the amount of reverse ventricular remodelling: results from the Markers and Response to CRT (MARC) study. Europace 2018; 20: e1-e10.
25. Tereshchenko L.G., Cheng A., Park J. et al.: Novel measure of electrical dyssynchrony predicts response in cardiac resynchronization therapy: Results from the SMART-AV Trial. Heart Rhythm 2015; 12: 2402-2410.
26. Barsheshet A., Goldenberg I., Moss A.J. et al.: Response to preventive cardiac resynchronization therapy in patients with ischaemic and nonischaemic cardiomyopathy in MADIT-CRT. Eur. Heart J. 2011; 32: 1622-1630.
27. Chatterjee N.A., Roka A., Lubitz S.A. et al.: Reduced appropriate implantable-cardioverter therapy after cardiac resynchronization therapy-induced left ventricular function recovery: a meta-analysis and systematic review. Eur. Heart J. 2015; 36: 2780-2799.
28. Singh J.P., Klein H.U., Huang D.T. et al.: Left ventricular lead position and clinical outcome in the multicenter automatic defibrillator implantation trial-cardiac resynchronization therapy (MADIT-CRT) trial. Circulation 2011; 123: 1159-1166.
29. Kutyifa V., Kosztin A., Klein H.U. et al.: Left Ventricular Lead Location and Long-Term Outcomes in Cardiac Resynchronization Therapy Patients. JACC Clin. Electrophysiol. 2018; 4: 1410-1420.
30. Gold M.R., Yu Y., Singh J.P. et al.: The effect of left ventricular electrical delay on AV optimization for cardiac resynchronization therapy. Heart Rhythm 2013; 10: 988-993.
31. Adelstein E.C., Saba S.: Scar burden by myocardial perfusion imaging predicts echocardiographic response to cardiac resynchronization therapy in ischemic cardiomyopathy. Am. Heart J. 2007; 153: 105-112.
32. Boriani G., Connors S., Kalarus Z. et al.: Cardiac Resynchronization Therapy With a Quadripolar Electrode Lead Decreases Complications at 6 Months: Results of the MORE-CRT Randomized Trial. JACC Clin. Electrophysiol. 2016; 2: 212-220.
33. Forleo G.B., Santini L., Giammaria M. et al.: Multipoint pacing via a quadripolar left-ventricular lead: preliminary results from the Italian registry on multipoint left-ventricular pacing in cardiac resynchronization therapy (IRON-MPP). Europace 2017; 19: 1170-1177.
34. Mazurek M., Jędrzejczyk-Patej E., Lenarczyk R. et al.: Do we need to monitor the percentage of biventricular pacing day by day? Int. J. Cardiol. 2016; 221: 81-89.
35. Daubert C., Behar N., Martins R.P. et al.: Avoiding non-responders to cardiac resynchronization therapy: a practical guide. Eur. Heart J. 2017; 38: 1463-1472.
36. Birnie D., Lemke B., Aonuma K. et al.: Clinical outcomes with synchronization left ventricular pacing: analysis of the adaptive CRT trial. Heart Rhythm 2013; 10: 1368-1374.
37. Altman R.K., Parks K.A., Schlett C.L. et al.: Multidisciplinary care of patients receiving cardiac resynchronization therapy is associated with improved clinical outcomes. Eur. Heart J. 2012; 33: 2181-2188.
38. Biffi M., Defaye P., Jais P. et al.: Benefits of left ventricular endocardial pacing comparing failed implants and prior non-responders to conventional cardiac resynchronization therapy: A subanalysis from the ALSYNC study. Int. J. Cardiol. 2018; 259: 88-93.
39. Reddy V.Y., Miller M.A., Neuzil P. et al.: Cardiac Resynchronization Therapy With Wireless Left Ventricular Endocardial Pacing: The SELECT-LV Study. J. Am. Coll. Cardiol. 2017; 69: 2119-2129.
40. Mafi-Rad M., Luermans J.G., Blaauw Y. et al.: Feasibility and Acute Hemodynamic Effect of Left Ventricular Septal Pacing by Transvenous Approach Through the Interventricular Septum. Circ. Arrhythm. Electrophysiol. 2016; 9: e003344.
41. Sharma P.S., Dandamudi G., Herweg B. et al.: Permanent His-bundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy: A multicenter experience. Heart Rhythm 2018; 15: 413-420.
42. Merkely B., Kosztin A., Roka A. et al.: Rationale and design of the BUDAPEST-CRT Upgrade Study: a prospective, randomized, multicentre clinical trial. Europace 2017; 19: 1549-1555.
43. ClinicalTrails.gov. CRT Implant Strategy Using the Longest Electrical Delay for Non-left Bundle Branch Block Patients (ENHANCE CRT). Dostęp 25.11.2018 r.