Cases in Cardiac Resynchronization Therapy

✍ Scribed by Cheuk-Man Yu, David Hayes, Angelo Auricchio

• Publisher: Saunders Elsevier
• Year: 2014
• Tongue: English
• Leaves: 290
• Edition: 1st
• Category: Library

✦ Synopsis

Cases in Cardiac Resynchronization Therapy, a brand-new medical reference book for cardiologists, electrophysiologists, surgeons, and primary care doctors, offers an informative and structured view of the newest approaches, treatments and follow-up care methods for heart failure patients treated with Cardiac Resynchronization Therapy. Complete with practical examples from top leaders in the field, this resource is designed to equip you with the cohesive, expert knowledge you need to make the best use of today's available technologies and research.

"This outstanding text will appeal to clinicians from widely varying backgrounds, and each will learn something valuable...This is a remarkable book and provides a truly unique perspective on this important clinical practice." Foreword by: Kenneth A. Ellenbogen, Kontos Professor of Cardiology, May 2015
Key Features
Better manage the challenging clinical scenarios you may encounter with case studies that include a brief introduction, clinical decision-making techniques, evidence-based rationales, and selected references for further study.
Remain up-to-date in this rapidly evolving field with clinical recommendations, updates on the latest technological advances, troubleshooting techniques, and recent key clinical trials.
Access practical examples regarding the process for selecting and implanting devices, as well as follow-up care for heart-failure patients being treated with CRT.
Stay abreast of today's novel wireless technologies, information on robotic-assisted implantations, and current methodologies on VV optimization.
Access the complete contents online at Expert Consult.

✦ Table of Contents

Cardiac Resynchronization Therapy, 1e

Yu, Hayes, Auricchio

Section 1: Current Indications

1. Paroxysmal Afib

2. Permanent Afib

3. Pacemaker upgrade

4. Efficacy of CRT in RBBB

5. Issue of QRS 120 - 150 ms

6. Impact of right heart failure

7. Role of optimal medical therapy

Section 2: Expanding Indications of CRT

1. NYHA class I/II

2. Narrow QRS complex

3. Pacemaker indication

4. Intercommissural Lead Placement into a Right Ventricular Coronary Sinus

Section 3: Challenging CRT Implantation

1. Skill and techniques to handle difficult CS cannulation

2. Positioning of LV and/or RV leads

3. CS venoplasty

4. LV lead screw into the CS branch vein

5. The Utility of Active Fixation Lead in Unstable Left Ventricular Lead Positions within the Coronary Sinus for Left Ventricular Stimulation

6. Left side SVC

7. Surgical implantation of LV lead

8. Role of cardiac CT before implant

Section 4: New CRT Implantation Techniques

1. Endocardial LV lead - high approach

2. Endocardial LV lead - low approach

3. Transcutaneous endocardial LV lead implantation

4. Novel wireless technologies

5. 2 LV leads

6. Robotic assisted implantation

Section 5: Optimization of CRT Device

1. Atrioventricular optimization by transthoracic echocardiography in a patient with intra-atrial delay

2. VV optimization: Is it necessary ?

3. Programming LV lead vectors, including Quadra

4. How to detect loss of LV/RV pacing

5. How to ensure a high percentage of BV pacing

Section 6: Post-implant Follow-up

1. How to manage VT: total block after ablation

2. How to manage VT: prevention of effective pacing by frequent PVCs

3. How to manage AF

4. CRT-P upgrade to CRT-D

5. CRT-D downgrade to CRT-P

6. Persistent AF (no RA lead) than back to sinus

Section 7: Management of Complications of CRT

1. Guide wire fraction during CRT implantation and subsequent management

2. Diaphragmatic stimulation post-implant

3. LV lead extraction

4. LV lead extraction and replacement in occluded vein

5. Infection

Section 8: Non-responders of CRT

1. Role of dyssynchrony assessment: Echo

2. Role of dyssynchrony assessment: CMR

3. Role of scar burden versus distribution assessment by CMR in ischemic patients

4. Role of contractile reserve

5. Ablation of frequent VES

6. Role of add-on CCM

7. Switch off if worsening

8. Recognition of anodal stimulation

9. Significant residual or worsening mitral regurgitation (MitraClip)

Section 9: Device-based Diagnostics for HF Monitoring and Remote Monitoring

1. Intrathoracic impedance

2. Heart rate variability

3. Pulmonary pressure

4. LA Pressure

5. Role of remote monitoring in managing a CRT patient: Medical therapy and device optimization

6. Role of remote monitoring in managing a CRT patient: Atrial Fibrillation

✦ Subjects

Clinical Electrophysiology; Cardiology