Pacing, Defibrillators & Cardiac Resynchronisation Therapy

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Biology of the Sinus Node and its Disease

Moinuddin Choudhury, Mark R Boyett, Gwilym M Morris,

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Asia Pacific Online Symposium on Cardiac Rhythm Management

Shu Zhang, Seow Swee Chong, David O’Donnell

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Personalised CRT Using Smart Algorithms to Maximize Response

Christophe Leclercq, Haran Burri, Sing-Chien Yap

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Transcatheter Pacing: The Latest Real-World Experience

Lluis Mont, Paul Roberts, Christian Veltmann

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The Promise of Leadless Pacing

Katrina Mountfort, Reinoud Knops, Johannes Sperzel, et al

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Mahaim Accessory Pathways

Demosthenes G Katritsis, Hein J Wellens, Mark E Josephson,

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Cardiac Effects of Lightning Strikes

Theodoros Christophides, Sarosh Khan, Mahmood Ahmad, et al

About

Cardiac pacing is a well-established therapeutic tool improving the survival and quality of life in patients. Indications for permanent cardiac pacing include sinus node dysfunction, intermittent and incomplete atrioventricular block, and bundle branch block.

Cardiac pacing, in conjunction with beta-blocker therapy, can potentially reduce the risk of bradycardia-dependent QT prolongation, decrease heart-rate irregularities and reduce repolarisation heterogeneity.

Cardiac resynchronisation therapy (CRT) with biventricular pacing is an effective therapy in patients with advanced heart failure (HF) – New York Heart Association (NYHA) Class III or IV, an ejection fraction (EF) 120 ms.

CRT has also been shown to be effective for the prevention of HF in relatively asymptomatic patients with wide QRS. However, CRT is underutilised among eligible patients. Approximately one-third of patients do not respond to CRT due to various factors, including anatomic difficulties and suboptimal lead placement. To increase the effectiveness of CRT, it has been hypothesised that pacing at multiple left ventricular (LV) sites may provide more effective resynchronisation.

In clinical studies, use of MultiPoint pacing in HF patients undergoing CRT has been associated with increased haemodynamic and clinical benefits compared with conventional pacing, particularly in patients with the least improvement from biventricular pacing.

Related Articles

Articles

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Conduction System Pacing for Cardiac Resynchronisation

Parikshit S Sharma, Pugazhendhi Vijayaraman,

Published:

Citation: Arrhythmia & Electrophysiology Review 2021;10(1):51–58.

Leadless LV Endocardial Pacing and LBBAP

Baldeep S Sidhu, Justin Gould, Mark Elliott,

Published:

Citation: Arrhythmia & Electrophysiology Review 2021;10(1):45–50.

Anisotropic Cardiac Conduction

Irum D Kotadia, John Whitaker, Caroline H Roney,

Published:

Citation: Arrhythmia & Electrophysiology Review 2020;9(4):202–10.

Improving Cardiac Resynchronisation Therapy

George Thomas, Jiwon Kim, Bruce B Lerman,

Published:

Citation: Arrhythmia & Electrophysiology Review 2019;8(3):220–7.