Cardiac Resynchronization Therapy and its Potential Proarrhythmic Effect

Cardiac resynchronization therapy (CRT) has become an established adjunctive treatment to optimal pharmacologic therapy in patients with advanced chronic heart failure (CHF), diminished left ventricular (LV) function and intraventricular conduction delay. Although CRT has been shown to improve ventr...

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Bibliographic Details
Published in:Clinical cardiology (Mahwah, N.J.) N.J.), 2007-10, Vol.30 (10), p.498-502
Main Authors: Basu Ray, Indranill, Fendelander, Lahn, Singh, Jagmeet P.
Format: Article
Language:English
Subjects:
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Biological and medical sciences
Cardiac Pacing, Artificial - adverse effects
Cardiac Pacing, Artificial - mortality
cardiac resynchronization
Cardiology. Vascular system
Death, Sudden, Cardiac - prevention & control
defibrillators
Defibrillators, Implantable
Emergency and intensive care: neonates and children. Prematurity. Sudden death
Heart
heart failure
Heart Failure - therapy
Heart failure, cardiogenic pulmonary edema, cardiac enlargement
Humans
implantable devices
Intensive care medicine
Medical sciences
pacemakers
proarrhythmia
Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)
Reviews
Risk Factors
sudden cardiac death
Tachycardia, Ventricular - etiology
Tachycardia, Ventricular - mortality
Ventricular Dysfunction, Left - therapy
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Summary:Cardiac resynchronization therapy (CRT) has become an established adjunctive treatment to optimal pharmacologic therapy in patients with advanced chronic heart failure (CHF), diminished left ventricular (LV) function and intraventricular conduction delay. Although CRT has been shown to improve ventricular hemodynamics, quality of life and exercise capacity, there is some evidence that it may rarely potentiate ventricular arrhythmias. As CRT is considered for an expanded population of CHF patients, and left‐sided pacing is considered as an option for pacemaker‐indicated patients (potentially without defibrillator backup), the effect of these pacing modalities on the incidence of ventricular tachyarrhythmia must be systematically studied and mechanistically understood. Strategies to prospectively predict the proarrhythmic potential of LV epicardial pacing need to be developed, and therapy accordingly individualized. This review attempts to summarize the current information on proarrhythmia in resynchronization therapy. Copyright © 2007 Wiley Periodicals, Inc.
ISSN:0160-9289
1932-8737
DOI:10.1002/clc.17