Heart rhythm : the official journal of the Heart Rhythm Society
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Randomized Controlled Trial Multicenter Study Comparative Study
Clinical significance of ventricular tachyarrhythmias in patients treated with CRT-D.
Data on the outcome of cardiac resynchronization therapy with defibrillator (CRT-D) in patients developing ventricular arrhythmias are limited. ⋯ Slow VT episodes are predictive of subsequent fast VT/VF. Slow VT and fast VT/VF episodes in CRT-D patients are associated with an increased risk of subsequent HF/death. CRT-D-treated LBBB patients with slow VTs have a significantly higher risk of mortality.
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Randomized Controlled Trial Multicenter Study
Randomized trial of pacemaker and lead system for safe scanning at 1.5 Tesla.
Magnetic resonance imaging (MRI) of pacemakers is a relative contraindication because of the risks to the patient from potentially hazardous interactions between the MRI and the pacemaker system. Chest scans (ie, cardiac magnetic resonance scans) are of particular importance and higher risk. The previously Food and Drug Administration-approved magnetic resonance conditional system includes positioning restrictions, limiting the powerful utility of MRI. ⋯ This randomized trial demonstrates that the Advisa MRI pulse generator and CapSureFix MRI 5086MRI lead system is safe and effective in the 1.5 T MRI environment without positioning restrictions for MRI scans or limitations of body parts scanned.
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Randomized Controlled Trial Multicenter Study Comparative Study
Effect of defibrillation threshold testing on heart failure hospitalization or death in the Multicenter Automatic Defibrillator Implantation Trial-Cardiac Resynchronization Therapy (MADIT-CRT).
Defibrillation threshold (DFT) testing is commonly practiced at the time of implantable cardioverter-defibrillator (ICD) implant. The clinical consequence of ICD shocks delivered during DFT testing is unknown. ⋯ In patients with mild symptoms of HF, increasing number of ICD shocks and delivery of high energy ICD shocks during DFT testing was not associated with increased risk for HF or death or future VT/VF episodes.
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Randomized Controlled Trial Multicenter Study Comparative Study
Investigation of a novel algorithm for synchronized left-ventricular pacing and ambulatory optimization of cardiac resynchronization therapy: results of the adaptive CRT trial.
In patients with sinus rhythm and normal atrioventricular conduction, pacing only the left ventricle with appropriate atrioventricular delays can result in superior left ventricular and right ventricular function compared with standard biventricular (BiV) pacing. ⋯ The aCRT algorithm is safe and at least as effective as BiV pacing with comprehensive echocardiographic optimization.
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Randomized Controlled Trial Multicenter Study
Arrhythmia rate distribution and tachyarrhythmia therapy in an ICD population: results from the INTRINSIC RV trial.
Appropriate implantable cardioverter-defibrillator (ICD) therapy for ventricular tachycardia (VT) or ventricular fibrillation (VF) depends, in part, on the programming of tachycardia zones. ⋯ In a general ICD population, ATP treated VT effectively or obviated the need for shock. Most ventricular arrhythmias <250 bpm were not VF. Proper zone programming may identify and treat VT without shock.