The Electrophysiological Aspect

  • E. Bertaglia
Conference paper


Since the beginning of the 1980s, electrophysiologists have increased their role in the treatment of patients with left ventricular dysfunction: initially, with the introduction of implantable cardioverter-defibrillators (ICDs) to prevent sudden cardiac death [ 1], more recently, with the wide application of cardiac resynchronization therapy (CRT) to treat patients with heart failure and ventricular conduction delay [ 2,3]. Several randomized trials have demonstrated that biventricular (BIV) pacing in conjunction with drug therapy increases cardiac performance, improves quality of life, improves functional capacity, and reduces the hospitalization rate for heart failure (Table 1) [4-8].


Cardiac Resynchronization Therapy Biventricular Pace Heart Failure Population Cardiac Resynchronization Therapy Defibrillator Complete Left Bundle Branch Block 
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  1. 1.
    Mirowski M, Reid P, Mower M et al (1980) Termination of malignant ventricular arrhythmias with an implantable automatic defibrillator in human beings. N Engl J Med 303:322–324PubMedCrossRefGoogle Scholar
  2. 2.
    Cazeau S, Ritter P, Bakdach S et al (1994) Four chamber pacing in dilated cardiomyopathy. Pacing Clin Eelectrophysiol 17:1974–1979CrossRefGoogle Scholar
  3. 3.
    Auricchio A, Stellbrink C, Block M et al, for the PATH-CHF Study Group (1999) Effect of pacing chamber and atrioventricular delay on acute systolic function of paced patients with congestive heart failure. Circulation 99:2993–3001PubMedCrossRefGoogle Scholar
  4. 4.
    Cazeau S, Leclerq C, Lavergne T et al, for the MUSTIC Study (2001) Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med 12:873–880CrossRefGoogle Scholar
  5. 5.
    Abraham WT, Fisher WG, Smith AL et al (2002) Cardiac resynchronization in chronic heart failure. N Engl J Med 346:1845–1853PubMedCrossRefGoogle Scholar
  6. 6.
    Stellbrink C, Breithardt O, Franke A et al (2001) Impact of cardiac resynchronization therapy using hemodynamically optimized pacing on left ventricular remodelling in patients with congestive heart failure and ventricular conduction disturbances. J Am Coll Cardiol 38:1957–1965PubMedCrossRefGoogle Scholar
  7. 7.
    Contak CD Guidant cardiac resynchronization therapy defibrillator system including the CONTAK CD pulse generator and the EASYTRAK left ventricular coronary venous lead. Summary of safety and effectiveness.
  8. 8.
    Medtronic InSync ICD cardiac resynchronization system.
  9. 9.
    Haywood G (2001) Biventricular pacing in heart failure: update and results from clinical trials. Curr Control Trials Cardiovasc 2:292–297CrossRefGoogle Scholar
  10. 10.
    Shenkman HJ, Pampati V, Khandelwal AK et al (2002) Congestive heart failure and QRS duration: establishing prognosis study. Chest 122:528–534PubMedCrossRefGoogle Scholar
  11. 11.
    Baldasseroni S, Boffa GM, Camerini A et al, on behalf of IN-CHF Investigators (2002) Left but not bundle branch block is an independent predictor of prognosis in patients with heart failure: report from the IN-CHF registry (abstract). Eur Heart J 23 [Suppl]:645Google Scholar
  12. 12.
    Khan NK, Louis AA, de Silva R et al, on behalf of the Euroheart Failure Investigators (2002) The Euroheart failure survey: the value of the electrocardiogram in the evaluation of heart failure (abstract). Eur Heart J 23 [Suppl]:707Google Scholar
  13. 13.
    Alonso C, Leclerq C, Victor F et al (1999) Electrocardiographic predictive factors of long-term clinical improvement with multisite biventricular pacing in advanced heart failure. Am J Cardiol 84:1417–1421PubMedCrossRefGoogle Scholar
  14. 14.
    Reuter S, Garrigue S, Barold SS et al (2002) Comparison of characteristics in responders versus nonresponders with biventricular pacing for drug-resistant congestive heart failure. Am J Cardiol 89:346–350PubMedCrossRefGoogle Scholar
  15. 15.
    Oguz E, Dagdeviren B, Bilsel T et al (2002) Echocardiographic prediction of longterm response to biventricular pacemaker in severe heart failure. Eur J Heart Fail 4:83–90PubMedCrossRefGoogle Scholar
  16. 16.
    Yu Y, Lamp B, Butter C et al, on behalf of the PATH-CHF II Investigators (2002) Sensitivity and specificity of using QRS duration to predict chronic benefit in heart failure patients with cardiac resynchronization therapy. Eur Heart J 23 [Suppl]:414CrossRefGoogle Scholar
  17. 17.
    Soogard P, Egeblad H, Kim Y et al (2002) Tissue Doppler Imaging predicts improved systolic performance and reversed left ventricular remodeling during long-term cardiac resynchronization therapy. J Am Coll Cardiol 40:723–730CrossRefGoogle Scholar
  18. 18.
    Moss AJ, Zareba W, Hall J et al, for the MADIT II Investigators (2002) Prophylactic implantation of a defibrillator in patients with myocardial infarction and reduced ejection fraction. N Engl J Med 346:877–883PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 2003

Authors and Affiliations

  • E. Bertaglia
    • 1
  1. 1.Department of CardiologyOspedale CivileMiranoItaly

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