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Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging
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| Zeitschriftentitel: | Journal of the American Heart Association |
|---|---|
| Personen und Körperschaften: | , , , , , , , , , |
| In: | Journal of the American Heart Association, 7, 2018, 23 |
| Format: | E-Article |
| Sprache: | Englisch |
| veröffentlicht: |
Ovid Technologies (Wolters Kluwer Health)
|
| Schlagwörter: |
| author_facet |
Gage, Ryan M. Khan, Akbar H. Syed, Imran S. Bajpai, Ambareesh Burns, Kevin V. Curtin, Antonia E. Blanchard, Amanda L. Gillberg, Jeffrey M. Ghosh, Subham Bank, Alan J. Gage, Ryan M. Khan, Akbar H. Syed, Imran S. Bajpai, Ambareesh Burns, Kevin V. Curtin, Antonia E. Blanchard, Amanda L. Gillberg, Jeffrey M. Ghosh, Subham Bank, Alan J. |
|---|---|
| author |
Gage, Ryan M. Khan, Akbar H. Syed, Imran S. Bajpai, Ambareesh Burns, Kevin V. Curtin, Antonia E. Blanchard, Amanda L. Gillberg, Jeffrey M. Ghosh, Subham Bank, Alan J. |
| spellingShingle |
Gage, Ryan M. Khan, Akbar H. Syed, Imran S. Bajpai, Ambareesh Burns, Kevin V. Curtin, Antonia E. Blanchard, Amanda L. Gillberg, Jeffrey M. Ghosh, Subham Bank, Alan J. Journal of the American Heart Association Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging Cardiology and Cardiovascular Medicine |
| author_sort |
gage, ryan m. |
| spelling |
Gage, Ryan M. Khan, Akbar H. Syed, Imran S. Bajpai, Ambareesh Burns, Kevin V. Curtin, Antonia E. Blanchard, Amanda L. Gillberg, Jeffrey M. Ghosh, Subham Bank, Alan J. 2047-9980 Ovid Technologies (Wolters Kluwer Health) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/jaha.118.009559 <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Delayed enhancement ( <jats:styled-content style="fixed-case">DE</jats:styled-content> ) on magnetic resonance imaging is associated with ventricular arrhythmias, adverse events, and worse left ventricular mechanics. We investigated the impact of <jats:styled-content style="fixed-case">DE</jats:styled-content> on cardiac resynchronization therapy ( <jats:styled-content style="fixed-case">CRT</jats:styled-content> ) outcomes and the effect of <jats:styled-content style="fixed-case">CRT</jats:styled-content> optimization. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> We studied 130 patients with ejection fraction ( <jats:styled-content style="fixed-case">EF</jats:styled-content> ) ≤40% and <jats:styled-content style="fixed-case">QRS</jats:styled-content> ≥120 ms, contrast cardiac magnetic resonance imaging, and both pre‐ and 1‐year post‐ <jats:styled-content style="fixed-case">CRT</jats:styled-content> echocardiograms. Sixty‐three (48%) patients did not have routine optimization of <jats:styled-content style="fixed-case">CRT</jats:styled-content> . The remaining patients were optimized for wavefront fusion by 12‐lead <jats:styled-content style="fixed-case">ECG</jats:styled-content> . The primary end point in this study was change in <jats:styled-content style="fixed-case">EF</jats:styled-content> following <jats:styled-content style="fixed-case">CRT</jats:styled-content> . To investigate the association between electrical dyssynchrony and <jats:styled-content style="fixed-case">EF</jats:styled-content> outcomes, the standard deviation of activation times from body‐surface mapping was calculated during native conduction and selected device settings in 52 of the optimized patients. Patients had no <jats:styled-content style="fixed-case">DE</jats:styled-content> (n=45), midwall septal stripe (n=30), or scar (n=55). Patients without <jats:styled-content style="fixed-case">DE</jats:styled-content> had better ∆ <jats:styled-content style="fixed-case">EF</jats:styled-content> (13±10 versus 4±10 units; <jats:italic>P</jats:italic> <0.01). Optimized patients had greater ∆ <jats:styled-content style="fixed-case">EF</jats:styled-content> in midwall stripe (2±9 versus 12±12 units; <jats:italic>P</jats:italic> =0.01) and scar (0±7 versus 5±10; <jats:italic>P</jats:italic> =0.04) groups, but not in the no‐ <jats:styled-content style="fixed-case">DE</jats:styled-content> group. Patients without <jats:styled-content style="fixed-case">DE</jats:styled-content> had greater native standard deviation of activation times ( <jats:italic>P</jats:italic> =0.03) and greater ∆standard deviation of activation times with standard programming ( <jats:italic>P</jats:italic> =0.01). Device optimization reduced standard deviation of activation times only in patients with <jats:styled-content style="fixed-case">DE</jats:styled-content> ( <jats:italic>P</jats:italic> <0.01). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">DE</jats:styled-content> on magnetic resonance imaging is associated with worse <jats:styled-content style="fixed-case">EF</jats:styled-content> outcomes following <jats:styled-content style="fixed-case">CRT</jats:styled-content> . Device optimization is associated with improved <jats:styled-content style="fixed-case">EF</jats:styled-content> and reduced electrical dyssynchrony in patients with <jats:styled-content style="fixed-case">DE</jats:styled-content> . </jats:p> </jats:sec> Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging Journal of the American Heart Association |
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10.1161/jaha.118.009559 |
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Ovid Technologies (Wolters Kluwer Health), 2018 |
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Ovid Technologies (Wolters Kluwer Health), 2018 |
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2018 |
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Ovid Technologies (Wolters Kluwer Health) |
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Journal of the American Heart Association |
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49 |
| title |
Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_unstemmed |
Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_full |
Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_fullStr |
Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_full_unstemmed |
Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_short |
Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_sort |
twelve‐lead ecg optimization of cardiac resynchronization therapy in patients with and without delayed enhancement on cardiac magnetic resonance imaging |
| topic |
Cardiology and Cardiovascular Medicine |
| url |
http://dx.doi.org/10.1161/jaha.118.009559 |
| publishDate |
2018 |
| physical |
|
| description |
<jats:sec xml:lang="en">
<jats:title>Background</jats:title>
<jats:p xml:lang="en">
Delayed enhancement (
<jats:styled-content style="fixed-case">DE</jats:styled-content>
) on magnetic resonance imaging is associated with ventricular arrhythmias, adverse events, and worse left ventricular mechanics. We investigated the impact of
<jats:styled-content style="fixed-case">DE</jats:styled-content>
on cardiac resynchronization therapy (
<jats:styled-content style="fixed-case">CRT</jats:styled-content>
) outcomes and the effect of
<jats:styled-content style="fixed-case">CRT</jats:styled-content>
optimization.
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Methods and Results</jats:title>
<jats:p xml:lang="en">
We studied 130 patients with ejection fraction (
<jats:styled-content style="fixed-case">EF</jats:styled-content>
) ≤40% and
<jats:styled-content style="fixed-case">QRS</jats:styled-content>
≥120 ms, contrast cardiac magnetic resonance imaging, and both pre‐ and 1‐year post‐
<jats:styled-content style="fixed-case">CRT</jats:styled-content>
echocardiograms. Sixty‐three (48%) patients did not have routine optimization of
<jats:styled-content style="fixed-case">CRT</jats:styled-content>
. The remaining patients were optimized for wavefront fusion by 12‐lead
<jats:styled-content style="fixed-case">ECG</jats:styled-content>
. The primary end point in this study was change in
<jats:styled-content style="fixed-case">EF</jats:styled-content>
following
<jats:styled-content style="fixed-case">CRT</jats:styled-content>
. To investigate the association between electrical dyssynchrony and
<jats:styled-content style="fixed-case">EF</jats:styled-content>
outcomes, the standard deviation of activation times from body‐surface mapping was calculated during native conduction and selected device settings in 52 of the optimized patients. Patients had no
<jats:styled-content style="fixed-case">DE</jats:styled-content>
(n=45), midwall septal stripe (n=30), or scar (n=55). Patients without
<jats:styled-content style="fixed-case">DE</jats:styled-content>
had better ∆
<jats:styled-content style="fixed-case">EF</jats:styled-content>
(13±10 versus 4±10 units;
<jats:italic>P</jats:italic>
<0.01). Optimized patients had greater ∆
<jats:styled-content style="fixed-case">EF</jats:styled-content>
in midwall stripe (2±9 versus 12±12 units;
<jats:italic>P</jats:italic>
=0.01) and scar (0±7 versus 5±10;
<jats:italic>P</jats:italic>
=0.04) groups, but not in the no‐
<jats:styled-content style="fixed-case">DE</jats:styled-content>
group. Patients without
<jats:styled-content style="fixed-case">DE</jats:styled-content>
had greater native standard deviation of activation times (
<jats:italic>P</jats:italic>
=0.03) and greater ∆standard deviation of activation times with standard programming (
<jats:italic>P</jats:italic>
=0.01). Device optimization reduced standard deviation of activation times only in patients with
<jats:styled-content style="fixed-case">DE</jats:styled-content>
(
<jats:italic>P</jats:italic>
<0.01).
</jats:p>
</jats:sec>
<jats:sec xml:lang="en">
<jats:title>Conclusions</jats:title>
<jats:p xml:lang="en">
<jats:styled-content style="fixed-case">DE</jats:styled-content>
on magnetic resonance imaging is associated with worse
<jats:styled-content style="fixed-case">EF</jats:styled-content>
outcomes following
<jats:styled-content style="fixed-case">CRT</jats:styled-content>
. Device optimization is associated with improved
<jats:styled-content style="fixed-case">EF</jats:styled-content>
and reduced electrical dyssynchrony in patients with
<jats:styled-content style="fixed-case">DE</jats:styled-content>
.
</jats:p>
</jats:sec> |
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| author | Gage, Ryan M., Khan, Akbar H., Syed, Imran S., Bajpai, Ambareesh, Burns, Kevin V., Curtin, Antonia E., Blanchard, Amanda L., Gillberg, Jeffrey M., Ghosh, Subham, Bank, Alan J. |
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| description | <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Delayed enhancement ( <jats:styled-content style="fixed-case">DE</jats:styled-content> ) on magnetic resonance imaging is associated with ventricular arrhythmias, adverse events, and worse left ventricular mechanics. We investigated the impact of <jats:styled-content style="fixed-case">DE</jats:styled-content> on cardiac resynchronization therapy ( <jats:styled-content style="fixed-case">CRT</jats:styled-content> ) outcomes and the effect of <jats:styled-content style="fixed-case">CRT</jats:styled-content> optimization. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> We studied 130 patients with ejection fraction ( <jats:styled-content style="fixed-case">EF</jats:styled-content> ) ≤40% and <jats:styled-content style="fixed-case">QRS</jats:styled-content> ≥120 ms, contrast cardiac magnetic resonance imaging, and both pre‐ and 1‐year post‐ <jats:styled-content style="fixed-case">CRT</jats:styled-content> echocardiograms. Sixty‐three (48%) patients did not have routine optimization of <jats:styled-content style="fixed-case">CRT</jats:styled-content> . The remaining patients were optimized for wavefront fusion by 12‐lead <jats:styled-content style="fixed-case">ECG</jats:styled-content> . The primary end point in this study was change in <jats:styled-content style="fixed-case">EF</jats:styled-content> following <jats:styled-content style="fixed-case">CRT</jats:styled-content> . To investigate the association between electrical dyssynchrony and <jats:styled-content style="fixed-case">EF</jats:styled-content> outcomes, the standard deviation of activation times from body‐surface mapping was calculated during native conduction and selected device settings in 52 of the optimized patients. Patients had no <jats:styled-content style="fixed-case">DE</jats:styled-content> (n=45), midwall septal stripe (n=30), or scar (n=55). Patients without <jats:styled-content style="fixed-case">DE</jats:styled-content> had better ∆ <jats:styled-content style="fixed-case">EF</jats:styled-content> (13±10 versus 4±10 units; <jats:italic>P</jats:italic> <0.01). Optimized patients had greater ∆ <jats:styled-content style="fixed-case">EF</jats:styled-content> in midwall stripe (2±9 versus 12±12 units; <jats:italic>P</jats:italic> =0.01) and scar (0±7 versus 5±10; <jats:italic>P</jats:italic> =0.04) groups, but not in the no‐ <jats:styled-content style="fixed-case">DE</jats:styled-content> group. Patients without <jats:styled-content style="fixed-case">DE</jats:styled-content> had greater native standard deviation of activation times ( <jats:italic>P</jats:italic> =0.03) and greater ∆standard deviation of activation times with standard programming ( <jats:italic>P</jats:italic> =0.01). Device optimization reduced standard deviation of activation times only in patients with <jats:styled-content style="fixed-case">DE</jats:styled-content> ( <jats:italic>P</jats:italic> <0.01). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">DE</jats:styled-content> on magnetic resonance imaging is associated with worse <jats:styled-content style="fixed-case">EF</jats:styled-content> outcomes following <jats:styled-content style="fixed-case">CRT</jats:styled-content> . Device optimization is associated with improved <jats:styled-content style="fixed-case">EF</jats:styled-content> and reduced electrical dyssynchrony in patients with <jats:styled-content style="fixed-case">DE</jats:styled-content> . </jats:p> </jats:sec> |
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| institution | DE-D275, DE-Bn3, DE-Brt1, DE-D161, DE-Zwi2, DE-Gla1, DE-Zi4, DE-15, DE-Pl11, DE-Rs1, DE-105, DE-14, DE-Ch1, DE-L229 |
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| publishDate | 2018 |
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| series | Journal of the American Heart Association |
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| spelling | Gage, Ryan M. Khan, Akbar H. Syed, Imran S. Bajpai, Ambareesh Burns, Kevin V. Curtin, Antonia E. Blanchard, Amanda L. Gillberg, Jeffrey M. Ghosh, Subham Bank, Alan J. 2047-9980 Ovid Technologies (Wolters Kluwer Health) Cardiology and Cardiovascular Medicine http://dx.doi.org/10.1161/jaha.118.009559 <jats:sec xml:lang="en"> <jats:title>Background</jats:title> <jats:p xml:lang="en"> Delayed enhancement ( <jats:styled-content style="fixed-case">DE</jats:styled-content> ) on magnetic resonance imaging is associated with ventricular arrhythmias, adverse events, and worse left ventricular mechanics. We investigated the impact of <jats:styled-content style="fixed-case">DE</jats:styled-content> on cardiac resynchronization therapy ( <jats:styled-content style="fixed-case">CRT</jats:styled-content> ) outcomes and the effect of <jats:styled-content style="fixed-case">CRT</jats:styled-content> optimization. </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Methods and Results</jats:title> <jats:p xml:lang="en"> We studied 130 patients with ejection fraction ( <jats:styled-content style="fixed-case">EF</jats:styled-content> ) ≤40% and <jats:styled-content style="fixed-case">QRS</jats:styled-content> ≥120 ms, contrast cardiac magnetic resonance imaging, and both pre‐ and 1‐year post‐ <jats:styled-content style="fixed-case">CRT</jats:styled-content> echocardiograms. Sixty‐three (48%) patients did not have routine optimization of <jats:styled-content style="fixed-case">CRT</jats:styled-content> . The remaining patients were optimized for wavefront fusion by 12‐lead <jats:styled-content style="fixed-case">ECG</jats:styled-content> . The primary end point in this study was change in <jats:styled-content style="fixed-case">EF</jats:styled-content> following <jats:styled-content style="fixed-case">CRT</jats:styled-content> . To investigate the association between electrical dyssynchrony and <jats:styled-content style="fixed-case">EF</jats:styled-content> outcomes, the standard deviation of activation times from body‐surface mapping was calculated during native conduction and selected device settings in 52 of the optimized patients. Patients had no <jats:styled-content style="fixed-case">DE</jats:styled-content> (n=45), midwall septal stripe (n=30), or scar (n=55). Patients without <jats:styled-content style="fixed-case">DE</jats:styled-content> had better ∆ <jats:styled-content style="fixed-case">EF</jats:styled-content> (13±10 versus 4±10 units; <jats:italic>P</jats:italic> <0.01). Optimized patients had greater ∆ <jats:styled-content style="fixed-case">EF</jats:styled-content> in midwall stripe (2±9 versus 12±12 units; <jats:italic>P</jats:italic> =0.01) and scar (0±7 versus 5±10; <jats:italic>P</jats:italic> =0.04) groups, but not in the no‐ <jats:styled-content style="fixed-case">DE</jats:styled-content> group. Patients without <jats:styled-content style="fixed-case">DE</jats:styled-content> had greater native standard deviation of activation times ( <jats:italic>P</jats:italic> =0.03) and greater ∆standard deviation of activation times with standard programming ( <jats:italic>P</jats:italic> =0.01). Device optimization reduced standard deviation of activation times only in patients with <jats:styled-content style="fixed-case">DE</jats:styled-content> ( <jats:italic>P</jats:italic> <0.01). </jats:p> </jats:sec> <jats:sec xml:lang="en"> <jats:title>Conclusions</jats:title> <jats:p xml:lang="en"> <jats:styled-content style="fixed-case">DE</jats:styled-content> on magnetic resonance imaging is associated with worse <jats:styled-content style="fixed-case">EF</jats:styled-content> outcomes following <jats:styled-content style="fixed-case">CRT</jats:styled-content> . Device optimization is associated with improved <jats:styled-content style="fixed-case">EF</jats:styled-content> and reduced electrical dyssynchrony in patients with <jats:styled-content style="fixed-case">DE</jats:styled-content> . </jats:p> </jats:sec> Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging Journal of the American Heart Association |
| spellingShingle | Gage, Ryan M., Khan, Akbar H., Syed, Imran S., Bajpai, Ambareesh, Burns, Kevin V., Curtin, Antonia E., Blanchard, Amanda L., Gillberg, Jeffrey M., Ghosh, Subham, Bank, Alan J., Journal of the American Heart Association, Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging, Cardiology and Cardiovascular Medicine |
| title | Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_full | Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_fullStr | Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_full_unstemmed | Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_short | Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| title_sort | twelve‐lead ecg optimization of cardiac resynchronization therapy in patients with and without delayed enhancement on cardiac magnetic resonance imaging |
| title_unstemmed | Twelve‐Lead ECG Optimization of Cardiac Resynchronization Therapy in Patients With and Without Delayed Enhancement on Cardiac Magnetic Resonance Imaging |
| topic | Cardiology and Cardiovascular Medicine |
| url | http://dx.doi.org/10.1161/jaha.118.009559 |