Cardiac Resynchronization Therapy in Patients with advanced  Heart Failure & wide QRS complex in Ibn Al Bitar hospital for  cardiac surgery 

  • Arshad Fuad Al Mustansiriyha Medical college
  • Amjad R Bairam Ibn Al bitar center for cardiac surgery

Abstract

Background: Evidence suggests that Cardiac Resynchronization Therapy  (CRT) is useful in patients with advanced heart failure (HF) & wide QRS  complexes despite optimal medical therapy  Objective: To demonstrate the beneficial effect of CRT in improving the  hemodynamic profile of patients with advanced HF despite optimal medical  therapy.  Methods: This prospective study enrolled 22 patients with advanced heart  failure (HF) who were selected from those patients who attend Ibn Al‐Bitar  center for cardiac surgery during the period from September 2010 to April  2011. All patients were subjected to thorough history taking and physical  examination  and  have  been  investigated  to  assess  their  eligibility  to  CRT.ECG and Echocardiography {assessing LV systolic & diastolic functions,  septal to posterior wall motion delay (SPWMD), left ventricular volumes, left  ventricle ejection fraction (LVEF) (by biplane Simpson’s method) and mitral  regurgitation (MR)} had been done to all patients before and 1 day after CRT  device implantation. Tei index calculated before and after CRT, comparing  responders and non‐responders.  Results:  Sixteen  patients  (72.7%)  are  matching  the  definition  of  the  responders. The responders have a decrease in QRS width (by 14.63%), LV  end‐diastolic diameter (by 6.35%), Tei index (by 14.85%), LV end‐systolic  volume (16.61%), and SPWMD (by 41.72%) with increase in EF (by 22.86%) in  comparison  to  the  non‐responder.Also  responders  patients  had  higher  mean initial Tei index (1.040) in comparison to non‐responders whose  their  mean initial Tei index was (0.9616).  Conclusions:  CRT has been shown to improve the functional status in a  majority of patients with drug –refractory Heart failure (ischemic, or dilated  cardiomyopathy), and Wide QRS complex & resulted in decrease rate of  hospitalization in responders. 

Published
2018-06-09
How to Cite
FUAD, Arshad; BAIRAM, Amjad R. Cardiac Resynchronization Therapy in Patients with advanced  Heart Failure & wide QRS complex in Ibn Al Bitar hospital for  cardiac surgery . Mustansiriya Medical Journal, [S.l.], v. 13, n. 2, p. 8, june 2018. ISSN 2227-4081. Available at: <http://mmj.uomustansiriyah.edu.iq/index.php/MMJ/article/view/212>. Date accessed: 10 apr. 2020.