Cardiac resynchronization therapy in heart failure patients: tough road but clear future
- PDF / 772,856 Bytes
- 11 Pages / 595.276 x 790.866 pts Page_size
- 96 Downloads / 196 Views
Cardiac resynchronization therapy in heart failure patients: tough road but clear future Ziyu Wang1 · Junmeng Zhang1 · Yongquan Wu1 Accepted: 7 October 2020 © Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Cardiac resynchronization therapy (CRT) based on biventricular pacing (BVP) is an invaluable intervention currently used in heart failure (HF) patients. The therapy involves electromechanical dyssynchrony, which can not only improve heart function and quality of life but also reduce hospitalization and mortality rates. However, approximately 30% to 40% of patients remain unresponsive to conventional BVP in clinical practice. In the recent years, extensive research has been employed to find a more physiological approach to cardiac resynchronization. The His-Purkinje system pacing (HPSP) including His bundle pacing (HBP) and left bundle branch area pacing (LBBaP) may potentially be the future of CRT. These technologies present various advantages including offering an almost real physiological pacing, less complicated procedures, and economic feasibility. Additionally, other methods, such as isolated left-ventricular pacing and multipoint pacing, may in the future be important but non-mainstream alternatives to CRT because currently, there is no strong evidence to support their effectiveness. This article reviews the current situation and latest progress in CRT, explores the existing technology, and highlights future prospects in the development of CRT. Keywords Cardiac resynchronization therapy · His bundle pacing · Left bundle branch area pacing · Isolated leftventricular pacing · Multipoint pacing
Introduction Cardiac resynchronization therapy (CRT) has for many years been the recommended treatment for heart failure (HF) in clinical guidelines [1]. The conventional CRT approach is based on biventricular pacing (BVP), which is able to improve heart function and quality of life as well as reduce hospitalization and mortality rates [2]. However, approximately 30–40% of patients unfavorably respond to conventional biventricular CRT [3]. To address the challenge of non-responsiveness, physicians and scholars resorted to a number of strategies including careful selection of patients, optimal device implantation, and post-implant device programming with long-term monitoring. Additionally, they adapted the new pacing forms, especially physiological pacing. With the occurrence of extensive clinical trials as well * Yongquan Wu [email protected] 1
Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, No. 2 Anzhen Road, Chaoyang District, Beijing 100029, China
as the advancement of technology, revolutionary changes in conventional CRT and breakthrough in the field of electrode implantation and pacing methods have been witnessed. The His-Purkinje system pacing, including His bundle pacing (HBP) and left bundle branch area pacing (LBBaP), is a true form of physiological pacing. This technology has been proven to achieve CRT with a number of unique advantages, su
Data Loading...
