Please use this identifier to cite or link to this item:
http://hdl.handle.net/1942/13427
Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | MULLENS, Wilfried | - |
dc.contributor.author | Grimm, Richard A. | - |
dc.contributor.author | Verga, Tanya | - |
dc.contributor.author | Dresing, Thomas | - |
dc.contributor.author | Starling, Randall C. | - |
dc.contributor.author | Wilkoff, Bruce L. | - |
dc.contributor.author | Tang, W. H. Wilson | - |
dc.date.accessioned | 2012-03-16T08:19:13Z | - |
dc.date.available | 2012-03-16T08:19:13Z | - |
dc.date.issued | 2009 | - |
dc.identifier.citation | JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 53 (9), p. 765-773 | - |
dc.identifier.issn | 0735-1097 | - |
dc.identifier.uri | http://hdl.handle.net/1942/13427 | - |
dc.description.abstract | Objectives Our aim was to determine the feasibility and value of a protocol-driven approach to patients with cardiac resynchronization therapy (CRT) who did not exhibit a positive response long after implant. Background Up to one-third of patients with advanced heart failure do not exhibit a positive response to CRT. Methods A total of 75 consecutive ambulatory patients with persistent advanced heart failure symptoms and/or adverse reverse remodeling and CRT implanted >6 months underwent a comprehensive protocol-driven evaluation to determine the potential reasons for a suboptimal response. Recommendations were made to maximize the potential of CRT, and adverse events were documented. Results All patients ( mean left ventricular [LV] ejection fraction 23 +/- 9%, LV end-diastolic volume 275 +/- 127 ml) underwent evaluation. Eighty-eight percent of patients had significantly better echocardiographic indexes of LV filling and LV ejection with optimal setting of their CRT compared with a temporary VVI back-up setting. Most patients had identifiable reasons for suboptimal response, including inadequate device settings (47%), suboptimal medical treatment (32%), arrhythmias ( 32%), inappropriate lead position (21%), or lack of baseline dyssynchrony ( 9%). Multidisciplinary recommendations led to changes in device settings and/or other therapy modifications in 74% of patients and were associated with fewer adverse events (13% vs. 50%, odds ratio: 0.2 [95% confidence interval: 0.07 to 0.56], p = 0.002) compared with those in which no recommendation could be made. Conclusions Routine protocol-driven approach to evaluate ambulatory CRT patients who did not exhibit a positive response is feasible, and changes in device settings and/or other therapies after multidisciplinary evaluation may be associated with fewer adverse events. | - |
dc.language.iso | en | - |
dc.subject.other | heart failure; cardiac resynchronization; optimization; disease management | - |
dc.title | Insights From a Cardiac Resynchronization Optimization Clinic as Part of a Heart Failure Disease Management Program | - |
dc.type | Journal Contribution | - |
dc.identifier.epage | 773 | - |
dc.identifier.issue | 9 | - |
dc.identifier.spage | 765 | - |
dc.identifier.volume | 53 | - |
local.bibliographicCitation.jcat | A1 | - |
local.type.refereed | Refereed | - |
local.type.specified | Article | - |
dc.bibliographicCitation.oldjcat | A1 | - |
dc.identifier.doi | 10.1016/j.jacc.2008.11.024 | - |
dc.identifier.isi | 000263667200006 | - |
item.fullcitation | MULLENS, Wilfried; Grimm, Richard A.; Verga, Tanya; Dresing, Thomas; Starling, Randall C.; Wilkoff, Bruce L. & Tang, W. H. Wilson (2009) Insights From a Cardiac Resynchronization Optimization Clinic as Part of a Heart Failure Disease Management Program. In: JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 53 (9), p. 765-773. | - |
item.accessRights | Open Access | - |
item.fulltext | With Fulltext | - |
item.contributor | MULLENS, Wilfried | - |
item.contributor | Grimm, Richard A. | - |
item.contributor | Verga, Tanya | - |
item.contributor | Dresing, Thomas | - |
item.contributor | Starling, Randall C. | - |
item.contributor | Wilkoff, Bruce L. | - |
item.contributor | Tang, W. H. Wilson | - |
crisitem.journal.issn | 0735-1097 | - |
crisitem.journal.eissn | 1558-3597 | - |
Appears in Collections: | Research publications |
Files in This Item:
File | Description | Size | Format | |
---|---|---|---|---|
insights from a cardiac resynchronization.pdf | 800.57 kB | Adobe PDF | View/Open |
SCOPUSTM
Citations
279
checked on Sep 5, 2020
WEB OF SCIENCETM
Citations
332
checked on Jul 11, 2024
Page view(s)
66
checked on Jul 31, 2023
Download(s)
306
checked on Jul 31, 2023
Google ScholarTM
Check
Altmetric
Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.