Biventricular pacing has been used to treat patients with symptomatic heart failure, systolic left ventricular dysfunction and intraventricular conduction delays. This modality is usually reserved for the treatment of patients with a left bundle branch block pattern on electrocardiogram. We report the successful use of biventricular pacing in a patient with heart failure and a right bundle bran...

A 74 year old man with dilated cardiomyopathy and right bundle branch block underwent implantation of a biventricular pacemaker for treatment of severe heart failure. When reviewed six weeks later his New York Heart Association functional class had improved from III to I. Using the Sonos 7500 Live 3D system, a real time transthoracic three dimensional echocardiogram was performed in the presenc...

Bernard Thibault, MD; Anique Ducharme, MD, MSc; François Harel, MD, PhD; Michel White, MD; Eileen O’Meara, MD; Marie-Claude Guertin, PhD; Joel Lavoie, PhD; Nancy Frasure-Smith, PhD; Marc Dubuc, MD; Peter Guerra, MD; Laurent Macle, MD; Léna Rivard, MD; Denis Roy, MD; Mario Talajic, MD; Paul Khairy, MD, PhD; for the Evaluation of Resynchronization Therapy for Heart Failure (GREATER-EARTH) Investi...

BACKGROUND Cardiac resynchronization therapy (CRT) for congestive heart failure patients with delayed left ventricular (LV) conduction is clinically beneficial in approximately 70% of patients. Unresolved issues include patient selection, lead placement, and efficacy of LV pacing alone. Being an electrical approach, detailed electrical information during CRT is critical to resolving these issue...

Cardiac resynchronization therapy (CRT) has evolved as an effective therapy for patients with congestive heart failure (CHF) and ventricular dyssynchrony, currently defined as a wide QRS on the electrocardiogram. While multiple randomized controlled trials have confirmed the favorable effects of CRT on mortality and heart failure symptoms for patients in sinus rhythm, only recently observationa...

BACKGROUND Cardiac resynchronization therapy (CRT) is efficacious in the treatment of chronic heart failure (CHF); however, because it is non-physiological, some patients are unresponsive. The present study used rate-adaptive atrioventricular delay (RAAVD) to track the physiological atrioventricular delay and investigated the effects of left univentricular pacing on CRT. MATERIAL AND METHODS Pa...

BACKGROUND Ventricular pacing can improve hemodynamics in heart failure patients, but direct effects on left ventricular (LV) function from varying pacing site and atrioventricular (AV) delay remain unknown. We hypothesized that the magnitude and location of basal intraventricular conduction delay critically influences pacing responses and that single-site pacing in the delay-activated region y...

BACKGROUND Normal coronary blood flow is principally determined by a backward-traveling decompression (suction) wave in diastole. Dyssynchronous chronic heart failure may attenuate suction, because regional relaxation and contraction overlap in timing. We hypothesized that biventricular pacing, by restoring left ventricular (LV) synchronization and improving LV relaxation, might increase this s...

BACKGROUND Biventricular pacing has been proposed to improve symptoms and exercise capacity in patients with advanced heart failure and wide electrocardiographic wave complexes. This study investigated the effect of biventricular pacing on reverse remodeling and the underlying mechanisms. METHODS AND RESULTS Twenty-five patients with NYHA class III to IV heart failure and electrocardiographic...