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Resynchronization Therapy in Heart Failure Patient
Introduction
Heart failure is the inability of the heart to perfuse metabolizing tissues adequately. The most common cause of this is myocardial failure, which can be caused by a wide variety of disease states.
Our body depends on the heart's pumping action to deliver oxygen- and nutrient-rich blood to the body's cells. When the cells are nourished properly, the body can function normally. With heart failure, the weakened heart can't supply the cells with enough blood. This results in fatigue and shortness of breath. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult.
Heart failure is a serious condition, and usually there's no cure. But many people with heart failure lead a full, enjoyable life when the condition is managed with medications and healthy lifestyle changes. It's also helpful to have the support of family and friends who understand your condition.
Epidemiology
Most patients have heart failure at their older age. And leads to frequent of hospitalization in people older than 65. About 5 million people in USA are affected by heart failure and about 500,000 new cases are diagnosed each year. What is of more concern is that more than 50% of patients seek re-admission within 6 months after treatment and the average duration of hospital stay is 6 days.
The common causes of heart failure include heart attacks and other forms of ischemic heart disease, hypertension, valvular heart disease, and cardiomyopathy. Heart failure can cause a number of symptoms including shortness of breath (typically worse when lying flat, which is called universally agreed definition and challenges in definitive diagnosis. Treatment orthopnea), coughing, chronic venous congestion, ankle swelling, and exercise intolerance. Heart failure is often undiagnosed due to a lack of a commonly consists of lifestyle measures (such as decreased salt intake) and medications, and sometimes devices or even surgery.
Until recently, lifestyle changes, medication and, sometimes, heart surgery were the only treatment options. Patients with severe symptoms, however, received little, if any, relief from such approaches. To make matters worse, up to 40 percent of patients with CHF also have an arrhythmia that further reduces the heart’s ability to beat properly.
Cardiac Resynchronization Device
Cardiac resynchronization therapy (CRT) is an innovative new therapy
that can relieve CHF symptoms by improving the coordination of
the heart’s contractions.CRT builds on the technology used in pacemakers and implantable cardioverter devices. CRT devices also can protect the patient from slow and fast heart rhythms.
The concept behind CRT is quite simple. Resynchronization restores the normal coordinated pumping action of the ventricles by overcoming the delay in electrical conduction caused by bundle branch block. This is accomplished by means of a special type of cardiac device. These powerful, “built-in” devices have enormous potential to improve the quality of life and probably survival for patients with heart failure.
Pacemakers are typically used to prevent symptoms due to an excessively
slow heartbeat. The pacemaker continuously monitors the heartbeat
and, when necessary, delivers tiny, imperceptible electrical signals to
stimulate the heartbeat. Most pacemakers have two electrode wires,
or leads, one in the right atrium and one in the right ventricle. This
ensures the pacemaker will maintain the normal coordinated pumping
relationship between the upper and lower chambers of the heart.
The wires that carry the electrical signals connect to an electrical pulse
generator placed under the skin in the upper chest. In addition to the
two leads (right atrium and right ventricle) used by a common pacemaker,
the CRT device has a third lead that is positioned in a vein on the surface of the left ventricle.
This allows the CRT device to simultaneously stimulate the left and right ventricles and restore a coordinated, or “synchronous,” squeezing pattern. This is sometimes referred to as “bi-ventricular pacing” because both ventricles are electrically stimulated (paced) at the same time. This reduces the electrical delay and results in a more coordinated and effective heart beat.
Outcome of CRT
Canadian researchers report that an implantable device called a resynchronization therapy-defibrillator helps keep the left side of the heart pumping properly, extending the life of heart failure patients. Cardiac-resynchronization therapy, or CRT-D, also reduces heart failure symptoms, such as edema (swelling) and shortness of breath, as well as hospitalizations for some patients with moderate to severe heart failure, the scientists added.
People who are receiving good medical therapy and resynchronization therapy as well, are shown to stay out of the hospital and live longer than none. The report is published in the Nov. 14 online edition of the New England Journal of Medicine.
Cardiac-resynchronization therapy alone or together with an implantable cardioverter-defibrillator has previously been shown to reduce mortality and hospitalizations in patients with moderate to severe heart failure.
Combined medical therapy and device therapy for patients with mild, moderate and severe heart failure can substantially improve survival and reduce the likelihood of hospitalization. The cumulative benefits offered to heart failure patients by evidence-based medication and device-based therapies are truly remarkable.
Heart failure is the inability of the heart to perfuse metabolizing tissues adequately. The most common cause of this is myocardial failure, which can be caused by a wide variety of disease states.
Our body depends on the heart's pumping action to deliver oxygen- and nutrient-rich blood to the body's cells. When the cells are nourished properly, the body can function normally. With heart failure, the weakened heart can't supply the cells with enough blood. This results in fatigue and shortness of breath. Everyday activities such as walking, climbing stairs or carrying groceries can become very difficult.
adopted from http://www.covenantheartinstitute.com/default
Heart failure is a serious condition, and usually there's no cure. But many people with heart failure lead a full, enjoyable life when the condition is managed with medications and healthy lifestyle changes. It's also helpful to have the support of family and friends who understand your condition.
Epidemiology
Most patients have heart failure at their older age. And leads to frequent of hospitalization in people older than 65. About 5 million people in USA are affected by heart failure and about 500,000 new cases are diagnosed each year. What is of more concern is that more than 50% of patients seek re-admission within 6 months after treatment and the average duration of hospital stay is 6 days.
The common causes of heart failure include heart attacks and other forms of ischemic heart disease, hypertension, valvular heart disease, and cardiomyopathy. Heart failure can cause a number of symptoms including shortness of breath (typically worse when lying flat, which is called universally agreed definition and challenges in definitive diagnosis. Treatment orthopnea), coughing, chronic venous congestion, ankle swelling, and exercise intolerance. Heart failure is often undiagnosed due to a lack of a commonly consists of lifestyle measures (such as decreased salt intake) and medications, and sometimes devices or even surgery.
Until recently, lifestyle changes, medication and, sometimes, heart surgery were the only treatment options. Patients with severe symptoms, however, received little, if any, relief from such approaches. To make matters worse, up to 40 percent of patients with CHF also have an arrhythmia that further reduces the heart’s ability to beat properly.
Cardiac Resynchronization Device
Cardiac resynchronization therapy (CRT) is an innovative new therapy
that can relieve CHF symptoms by improving the coordination of
the heart’s contractions.CRT builds on the technology used in pacemakers and implantable cardioverter devices. CRT devices also can protect the patient from slow and fast heart rhythms.
The concept behind CRT is quite simple. Resynchronization restores the normal coordinated pumping action of the ventricles by overcoming the delay in electrical conduction caused by bundle branch block. This is accomplished by means of a special type of cardiac device. These powerful, “built-in” devices have enormous potential to improve the quality of life and probably survival for patients with heart failure.
Pacemakers are typically used to prevent symptoms due to an excessively
slow heartbeat. The pacemaker continuously monitors the heartbeat
and, when necessary, delivers tiny, imperceptible electrical signals to
stimulate the heartbeat. Most pacemakers have two electrode wires,
or leads, one in the right atrium and one in the right ventricle. This
ensures the pacemaker will maintain the normal coordinated pumping
relationship between the upper and lower chambers of the heart.
The wires that carry the electrical signals connect to an electrical pulse
generator placed under the skin in the upper chest. In addition to the
two leads (right atrium and right ventricle) used by a common pacemaker,
the CRT device has a third lead that is positioned in a vein on the surface of the left ventricle.
adopted from http://www.medicalproductguide.com/
This allows the CRT device to simultaneously stimulate the left and right ventricles and restore a coordinated, or “synchronous,” squeezing pattern. This is sometimes referred to as “bi-ventricular pacing” because both ventricles are electrically stimulated (paced) at the same time. This reduces the electrical delay and results in a more coordinated and effective heart beat.
Outcome of CRT
Canadian researchers report that an implantable device called a resynchronization therapy-defibrillator helps keep the left side of the heart pumping properly, extending the life of heart failure patients. Cardiac-resynchronization therapy, or CRT-D, also reduces heart failure symptoms, such as edema (swelling) and shortness of breath, as well as hospitalizations for some patients with moderate to severe heart failure, the scientists added.
People who are receiving good medical therapy and resynchronization therapy as well, are shown to stay out of the hospital and live longer than none. The report is published in the Nov. 14 online edition of the New England Journal of Medicine.
Cardiac-resynchronization therapy alone or together with an implantable cardioverter-defibrillator has previously been shown to reduce mortality and hospitalizations in patients with moderate to severe heart failure.
Combined medical therapy and device therapy for patients with mild, moderate and severe heart failure can substantially improve survival and reduce the likelihood of hospitalization. The cumulative benefits offered to heart failure patients by evidence-based medication and device-based therapies are truly remarkable.
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