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Your search keyword '"V. V. Slobodyanik"' showing total 2 results
Start Over Author "V. V. Slobodyanik" Topic cardiac resynchronization therapy
2 results on '"V. V. Slobodyanik"'

1. CARDIAC RESYNCHRONIZATION THERAPY AND MYOCARDIAL PERFUSION OF THE LEFT AND RIGHT VENTRICLES

Author

E. N. Ostroumov, E. D. Kotina, V. A. Shmyrov, V. V. Slobodyanik, V. V. Tonkoshkurova, N. P. Mozeiko, I. M. Ilyinski, and D. V. Shumakov

Subjects
cardiac resynchronization therapy, gated spect, the ratio of the level of perfusion of the lateral walls of lv and rv., Surgery, RD1-811
Abstract

The decision to install cardiac resynchronization device in patients may be associated not with the apparent clini- cal effectiveness, but for other reasons that require medical consultation. This may be due to the need to create a «bridge» to heart transplantation (HT), for example. In order to predict the outcome of CRT, we observed 54 pa- tients with HF, III–IV functional class NYHA, on the waiting list for HT. Cardiomyopathy was diagnosed in 36 patients, various forms of ischemic heart disease was diagnosed in 17 patients, all with the ECG determined left bundle branch block with QRS complex duration of less than 120 ms. All patients performed gated SPECT before and after CRT with standard methods of research. LVEF at baseline did not exceed 35%. Monitoring was continued for 2 years after the start of the CRT. The results were divided into two groups. Group 1 consisted of patients who need HT for 2 years, in spite of the CRT (11 patients). Group 2 consisted of patients who have an increase in LVEF of at least 10% after CRT (28 patients). When comparing the initial and final performance with the help of the Main- Whitney in both groups, most significant differences were found in the assessment of myocardial perfusion relation- ships lateral walls of LV and RV. The decrease in the ratio between the level of perfusion of the lateral walls of LV and RV < 2,0 reduces the effectiveness of CRT, and within two years, there occured a need for a heart transplant.

Published
2012
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2. [Assessment of myocardial electrical dissynchrony by noninvasive activation mapping and its role in achieving the success of cardiac resynchronization]

Author

N. A. Mironova, E. M. Gupalo, S. A. Gaman, V. V. Slobodyanik, G. S. Tarasovskiy, Sergey P. Golitsyn, T A Malkina, S. Yu. Kashtanova, and M A Saidova

Subjects
Electroanatomic mapping, medicine.medical_specialty, Ventricular Ejection Fraction, medicine.medical_treatment, Bundle-Branch Block, Cardiac resynchronization therapy, 030204 cardiovascular system & hematology, Cardiac Resynchronization Therapy, 03 medical and health sciences, QRS complex, Electrocardiography, 0302 clinical medicine, Internal medicine, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, Aged, Heart Failure, Ejection fraction, Bundle branch block, business.industry, Myocardium, Middle Aged, medicine.disease, Treatment Outcome, Heart failure, Cardiac resynchronization, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract

Purpose. To assess and to compare the ventricular myocardium activation patern obtained by non-invasive epi- and endocardial mapping (NIEEM), as well as electrocardiographic (ECG) variants of lef bundle branch block (LBBB) and to estimate the value of these data for the success of cardiac resynchronization therapy (CRT).Materials and methods. Te study included 23 patients (mean age 59,6±9,9 years) with LBBB, QRS duration ≥ 130 ms, lef ventricular ejection fraction (LVEF) ≤ 35%, heart failure (HF) NYHA II-IV despite optimal pharmacological therapy during 3 month. All patients had undergone CRT-D implantation. Depending on presence or absence of LBBB ECG-criteria, proposed by Strauss D.G. et. al, patients were divided into 2 groups: 1group - strict LBBB, proposed by Strauss D.G. et. al. (n=14) and 2 group – other ECG morphologies of LBBB (n=9). NIEEM by the Amycard 01C system with an analysis of epi- and endocardial ventricular electrical activation was performed in all patients and 5 healthy volunteers (mean age 29±1,0years). Response to CRT was estimated by echo and was defned as decrease in lef ventricular (LV) end-systolic volume by > 15% afer 6 months of follow-up.Results. LBBB ECG-criteria, proposed by Strauss D.G. et. al, was detected in 14 patients (61% of all included). According to the results of NIEEM, these patients had more pronounced ventricular electrical uncoupling (VEU) (р=0,002). Most ofen the line of block was detected in the anteroseptal or posterolateral region of the LV. Te zone of late LV activation, which is the most optimal position for the LV pacing electrode, was located in the basal and middle segments of the lateral and posterior walls. Afer 6 months of CRT 15 patients (65%) were included in the "response" group, the remaining 8 patients (35%) formed the "non-response" group according to echo criteria. In the "response" group the morphology of the QRS complex more frequently met the criteria, proposed by Strauss D.G. et al, than other ECG variants of LBBB (12 vs. 3 respectively, p = 0.023). Initially, VEU was more pronounced in the "response" group (VEU 55 [51, 64] ms in the "response" group vs 22 [8, 38] ms in the "non-response" group).Сonclusions. LBBB ECG criteria, proposed by Strauss D.G., identify patients with delayed transseptal interventricular conduction due to complete LBBB, what is a good target for CPT. Identifcation of individual ventricular activation properties may help to reveal responders to CRT in patients with LBBB.

Published
2019

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