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Cardiovascular diseases are the most common cause of mortality and morbidity in adults worldwide.1 Coronary angiography (CAG) is the gold standard method for evaluating atherosclerotic coronary artery disease (CAD).2 It is conventionally performed via the trans-femoral (TF) route. Recently, however, the trans-radial (TR) route has become the preferred way.3 The TR route offers better procedure comfort, shorter hospitalization […]

Bruce Wilkoff, EHRA 2023: An overview of cardiac resynchronization therapy for patients with heart failure

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Published Online: May 26th 2023

Cardiac resynchronization therapy is designed to restore the electrical activation in a more natural way in patients with heart failure. In this touchCARDIO interview, we speak with Dr Bruce Wilkoff (Cleveland Clinic, Cleveland, OH, USA) to discuss the treatment paradigm with focus on cardiac resynchronization therapy for patients with heart failure.

Bruce Wilkoff presented an abstract entitled ‘AdaptResponse: A randomized study of synchronized LV pacing’ at the European Heart Rhythm Association congress, 16–18, April 2023.

Click here to view the AdaptResponse trial video.

Question:

Can you give us a brief overview of the treatment paradigm for congestive heart failure associated with left bundle branch block, and the use of cardiac resynchronization therapy (CRT) devices? (00:25)

Disclosures: Bruce Wilkoff is a consultant for and has received honoraria from Abbott, Biotronik, Boston Scientific and Medtronic.

Support: Interview and filming supported by Touch Medical Media. Interview conducted by Danielle Crosby.

Filmed as a highlight of EHRA 2023

Access more content on atrial fibrillation here

 

Transcript:

Hello I’m Dr Bruce Wilkoff. I’m director of cardiac pacing and tachyarrhythmia devices at the Cleveland Clinic. I’m the holder of the Deb Dow chair for lead management. 

Q. Can you give us a brief overview of the treatment paradigm for congestive heart failure associated with left bundle branch block, and the use of cardiac resynchronization therapy (CRT) devices?

Cardiac resynchronization therapy is designed to restore the electrical activation in a more natural way. Interrupted by the fact that it works best for left bundle branch block patients. So naturally, the heart activates both the left and right side through the right and left bundles. When you have left bundle branch block, that message gets delayed to the left side. With cardiac resynchronization therapy, we pre-excite the left side, which would have been delayed, to synchronize it with the natural activation on the right side. Therefore, cardiac resynchronization therapy is resynchronizing the activation of the heart and therefore resynchronizing the contraction pattern of the heart, improving the ejection fraction, the symptoms, and in fact improving the outcomes, meaning hospitalizations and survival as well.

Subtitles and transcript are autogenerated

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