Fragmented QRS and Ventricular Dyssynchrony in a Patient Treated with Cardiac Resynchronization Therapy
نویسندگان
چکیده
Cardiac resynchronization is an established treatment modality in patients with heart failure NYHA class III-IV on optimal medical treatment, QRS duration of at least 120-130 ms and ejection fraction <35%. Nevertheless, a proportion of patients, up to 20-30%, are considered non-responders as they are not improved by cardiac resynchronization therapy (CRT). This report describes a 63-year-old patient with ischemic cardiomyopathy, severe mitral regurgitation, and fragmented QRS complex in several leads. The patient had LV dyssynchrony identified by echocardiographic tissue Doppler imaging. A biventricular pacemaker was implanted successfully, and resulted in improvement in LV dyssynchrony, LV dimensions, mitral regurgitation and symptoms. Fragmented QRS complex as a marker of ventricular dyssynchrony may play a role in identifying patients who may benefit from cardiac resynchronization therapy.
منابع مشابه
Benefit of cardiac resynchronization therapy to a patient with a narrow QRS complex and ventricular dyssynchrony identified by tissue synchronization imaging.
This report described an 81-year-old woman with severe symptomatic heart failure, reduced ejection fraction, mitral regurgitation, and an electrocardiographic QRS width of 118 ms who had ventricular dyssynchrony identified by echocardiographic tissue synchronization imaging. Because of her severe heart failure symptoms on maximal medical therapy, referral to implant a defibrillator, and mechani...
متن کاملCardiac resynchronization therapy in patients with a narrow QRS complex.
OBJECTIVES The purpose of this study was to evaluate the effects of cardiac resynchronization therapy (CRT) in heart failure patients with narrow QRS complex (<120 ms) and evidence of left ventricular (LV) dyssynchrony on tissue Doppler imaging (TDI). BACKGROUND Cardiac resynchronization therapy is beneficial in selected heart failure patients with wide QRS complex (> or =120 ms). Patients wi...
متن کاملVariations of QRS Morphology in Patients with Dilated Cardiomyopathy; Clinical and Prognostic Implications
The QRS represents the simultaneous activation of the right and left ventricles, although most of the QRS waveform is derived from the larger left ventricular musculature. Although normal QRS duration is <100 millisecond (ms), its duration and shape are quite variable from patient to patient in idiopathic dilated cardiomyopathy (IDCM). Prolongation of QRS occurs in 14% to 47% of heart failure (...
متن کاملIs Assessment of Systolic Dyssynchrony for Cardiac Resynchronization Therapy Clinically Useful? Assessment of Systolic Dyssynchrony for Cardiac Resynchronization Therapy Is Not Clinically Useful
Cardiac resynchronization therapy (CRT) is an effective treatment in patients with medically refractory heart failure. Several clinical trials have shown improvement in both left ventricular (LV) function and symptoms with CRT compared with controls,1–4 with the 2 largest trials showing a reduction in rates of hospitalization and death.5,6 On the basis of data from these studies, most internati...
متن کاملRegenerative Therapy Prevents Heart Failure Progression in Dyssynchronous Nonischemic Narrow QRS Cardiomyopathy
BACKGROUND Cardiac resynchronization therapy using bi-ventricular pacing is proven effective in the management of heart failure (HF) with a wide QRS-complex. In the absence of QRS prolongation, however, device-based resynchronization is reported unsuitable. As an alternative, the present study tests a regenerative cell-based approach in the setting of narrow QRS-complex HF. METHODS AND RESULT...
متن کامل