Cardiac Resynchronization Therapy EFFECTS ON EXERCISE CAPACITY IN THE PATIENT WITH CHRONIC HEART FAILURE
Arjun V. Gururaj MD

$7.95 		Journal of Cardiopulmonary Rehabilitation & Prevention
February 2004 
Volume 24  Number 1
Pages 1 - 7
 
  PDF Version Available!

ABSTRACT
Outline

  • THE PROBLEM: THE UNTOWARD EFFECTS OF INTERVENTRICULAR ASYNCHRONY

  • A SOLUTION: THE ADVENT OF BIVENTRICULAR PACING AND CRT

  • EXERCISE CAPACITY OF THE PATIENT WITH CHRONIC HEART FAILURE

  • THE EFFECTS OF CRT ON EXERCISE CAPACITY

  • CONCLUSIONS

  • References



    • Graphics

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    • As the population ages, the incidence of chronic heart failure will increase and remain an important health issue. Currently, almost 5 million people in the United States are affected by congestive heart failure (CHF), and the number of new patients with CHF is growing by 200,000 to 500,000 per year. 1 Despite prior major advances in pharmacologic therapies, medically refractory heart failure remains a significant source of morbidity and mortality. The presence of conduction abnormalities on the electrocardiogram (often left bundle branch block) may be present in up to 40% of individuals with moderate or severe heart failure. 2 Left bundle branch block delays left ventricular (LV) contraction and results in asynchronous right (RV) and left ventricular contraction. This interventricular asynchrony impairs cardiac performance and leads in many instances to more severe heart failure symptoms. Given that many patients with heart failure have limited exercise tolerance, further depression of cardiac function may be quite debilitating.

    Recently, cardiac resynchronization therapy (CRT) has become a promising new method for the treatment of these patients. By pacing the LV and RV simultaneously, the extent of interventricular asynchrony is reduced and cardiac performance improved. In large randomized trials, cardiac resynchronization has demonstrated convincing improvement in hemodynamic measures of cardiac performance. More importantly, ...

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