HF and CRT: CRT-P versus CRT-D
|
|
|
- Eleanore Boyd
- 6 years ago
- Views:
Transcription
1 HF and CRT: CRT-P versus CRT-D Andrew E. Epstein, MD Professor of Medicine, Cardiovascular Division University of Pennsylvania Chief, Cardiology Section Philadelphia VA Medical Center Philadelphia, PA
2 Research Grants: Disclosures Biotronik, Boston Scientific, Medtronic, St. Jude Medical Speaker s Bureaus/Honoraria: Biotronik, Boston Scientific, Medtronic, St. Jude Medical Advisor Relationships: Boston Scientific, St. Jude Medical EP Fellowship Program Support: Boston Scientific, Medtronic, St. Jude Medical
3 Control Group Mortality % SCD Risks in HF Patients with LV Dysfunction Total Mortality Sudden Cardiac Death CHF-STAT GESICA SOLVD V-HeFT I MERIT-HF CIBIS-II CARVEDILOL-US 45 months 13 months 41.4 months 27 months 12 months 16 months 6 months Total Mortality ~15-40%; SCD accounts for ~50% of total mortality. * MADIT II control group total mortality at 24 months 22%.
4 Secondary Prevention Trials: AVID/CASH/CIDS Meta-analysis 60 Death 60 Arrhythmic death % Amiodarone ICD Years % Amiodarone Years ICD Connolly et al. Eur Heart J 2000;21:
5 MADIT II Conventional versus ICD Therapy ICD Reduction in death rate with ICD Rx: 12% at 1 yr, 28% at 2 yrs, 28% at 3 yrs Probability of Survival Conventional Year No. At Risk Defibrillator (0.91) 274 (0.84) 110 (0.78) 9 Conventional (0.90) 170 (0.78) 65 (0.69) 3 P = Moss et al. N Engl J Med 2002;346:
6 SCD-HEFT Mortality by Intention-to-treat.4 HR 97.5% CI P Value Amiodarone vs Placebo , ICD Therapy vs Placebo.77.62, Mortality.2.1 Amiodarone ICD Therapy Placebo Months of Follow-up Bardy et al. N Engl J Med 2005;352:
7 CRT Improves Quality of Life and NYHA Functional Class Average Change in QoL Score (MLWHF) NYHA: Proportion Improving 1 or More Class % 60% * * * MIRACLE (1) * * * * MUSTIC SR (2) MUSTIC AF (3) CONTAK CD (4) MIRACLE ICD (5) 40% 20% 0% MIRACLE (1) CONTAK CD (4) MIRACLE ICD (5) Control CRT Control 1. NEJM 2002;346: NEJM 2001;344: Eur Heart J 2002;23: Accessed August 2, JAMA 2003; 289: CRT * P < 0.05
8 MADIT CRT: Changes in Mean LV Volumes and EF at 1 Year Moss AJ, et al. N Engl J Med 2009;361:
9 Trials of CRT and ICDs MADIT-CRT RAFT CRT-P COMPANION REVERSE CeRtiTuDe CRT-D
10 MADIT-CRT Moss et al. N Engl J Med 2009:361:
11
12
13 COMPANION: Primary Endpoint: Mortality+Hospitalization %% 2 M 9: 0 % 0 %%- 2ID D =E H =I 0 % ) 2 3 M 9: 0 % 0 %%, 2ID D =E H =I 0 % H := DA 4MA 5IAA -% % )% % % 8H C 4MA = A 9: ( : 2 6 -% 27 -.) % 27,.) % % )% ( % )-% %%, % -)%. % %-% 3= IHF = HFDO= DH Bristow et al. N Engl J Med 2004;350:
14 COMPANION: Secondary Endpoint: All-Cause Mortality %% 2 M 9: 0 ) 0 % % 2ID D =E H =I 0 % ) 2 3 M 9: 0( 0 %%( 2ID D =E H =I 0 % H := DA 4MA 5IAA.% -%,% % % 8H C 4MA = A 9: ) , 9: 2 6, 27 - % ) 27 )- - % % )% ( % )-% %%, % -)%. % %-% 3= IHF = HFDO= DH Bristow et al. N Engl J Med 2004;350:
15 25% 20% Univariate Analysis HR = 1.53 ( ), p = 0.18 Mortality 15% 10% Multivariate Analysis HR = 2.74, p = CRT-P 5% CRT-D 0% Months Post Implant Number at Risk CRT-P CRT-D Gold M, et al. Circ Arrhythm Electrophysiol 2013;6:
16 CeRtiTuDe! Prospective Multicenter Cohort Study Funded and Coordinated by the French Society of Cardiology! To evaluate the extent to which: CRT-P patients differ from CRT-D patients in real life settings CRT-P patients could have additionally benefited from a back-up defibrillator! Enrollment from Jan to Dec. 2010! 1,705 patients: 535 CRT-P and 1170 CRT-D! Follow-up at 6, 12, 18, and 24 months Clinical / Echo / Rhythm Completed in 1,611 (94.5%)
17 CeRtiTuDe - Overall Mortality Among the 1,611 patients with complete follow-up, 286 deaths CRT-D: 6.2 %/year CRT-P: 12.2 %/year
18 Why Consider CRT-P without D? 1. Both appropriate and inappropriate shocks are avoided. 2. Some patients may not want D. 3. Some CRT-P indications are independent of ICD indications. 4. If LVEF is anticipated to improve, the benefit of D may be minimized. 5. CRT-P saves lives (COMPANION and CARE-HF) 6. Decreased cost.
19 CRT Indications Algorithm J Am Coll Cardiol 2012;60:
20 DBT Considerations Regarding Longevity and Comorbidities: What are the Patient s Goals/Focus on the Elderly Physicians, patients, and their families increasingly will be faced with decisions about device-based therapies (ICD and CRT) in elderly patients who meet conventional criteria for implantation. These decisions require estimates of life expectancy, consideration of comorbidities and procedural risk, and patient preferences. Although these factors are important when device implantation is considered in any age group, they assume greater weight in clinical decision-making among the elderly. Epstein AE, et al. J Am Coll Cardiol 2013;61:e6-75.
21 Survival vs QOL Stevenson et al. J Am Coll Cardiol 2008;52:
22 Comorbidities and Survival Observational study of ICD outcomes in Canada 2,467 patients age 18 and 105 years Comorbidities associated with death - PVD - Pulmonary disease - CKD - HF HRs adjusted for age, gender, and HF - 1 noncardiac comorbidity: noncardiac comorbidities: noncardiac comorbidities: 2.98 Lee et al. J Am Coll Cardiol 2007;49:
23 Comorbidities and Survival Lee et al. J Am Coll Cardiol 2007;49:
24 Risk and Mortality in MADIT II: U-shaped Curve of ICD Efficacy 5 risk factor model Age NYHA class BUN Atrial fibrillation QRS duration Excluded VHR patients (BUN 50 and/or Cr 2.5 mg/dl [MADIT II exclusion BUN 70 and/or Cr 3.0 mg/dl]). N = 60 Goldenberg et al. J Am Coll Cardiol 2008;51:
25 Mortality by Risk Score Quintile in Patients with ICDs Bilchick KC, et al. J Am J Cardiol 2010;60:
26 CARE-HF Primary Endpoint (All-cause Mortality or Unplanned Hospitalization for Major CV Event) 1.00 Event-free Survival HR 0.63 (95% CI 0.51 to 0.77) CRT P < Medical Therapy 0.00 Number at risk CRT 409 Medical Therapy Days Cleland et al. N Engl J Med 2005;352:
27 Summary CRT alone (CRT-P) or with an ICD (CRT-D) is highly effective therapy to decrease morbidity and mortality. Almost all patients with a CRT-P indication have an indication for and ICD at the time of implantation, and CRT-D is reasonable. The decision to implant a CRT-P or CRT-D requires discussion with the patient and their telling you what are their goals. CRT-P is appropriate when LVEF is relatively wellpreserved and pacing is needed (CHB, AF/slow VR), but CRT-D is appropriate in borderline circumstances to avoid second operation/pocket opening.
The Role of ICD Therapy in Cardiac Resynchronization
The Role of ICD Therapy in Cardiac Resynchronization The Korean Society of Circulation 15 April 2005 Angel R. León, MD Carlyle Fraser Heart Center Division of Cardiology Emory University School of Medicine
Devices and Other Non- Pharmacologic Therapy in CHF. Angel R. Leon, MD FACC Division of Cardiology Emory University School of Medicine
Devices and Other Non- Pharmacologic Therapy in CHF Angel R. Leon, MD FACC Division of Cardiology Emory University School of Medicine Disclosure None University of Miami vs. OSU Renegade Miami football
THE ROLE OF ICD THERAPY FOR PRIMARY PREVENTION Leonard Ganz, M.D. Pittsburgh, PA
THE ROLE OF ICD THERAPY FOR PRIMARY PREVENTION Leonard Ganz, M.D. Pittsburgh, PA Speakers Bureau: Zoll / Lifecore, Sanofi Aventis, Cardionet Consultant: Boston Scientific, St. Jude Medical, Biotronik,
Primary prevention of SCD with the ICD in Nonischemic Cardiomyopathy
Primary prevention of SCD with the ICD in Nonischemic Cardiomyopathy Michael R Gold, MD, PhD Medical University of South Carolina Charleston, SC USA Disclosures: Consulting and Clinical Trials Medtronic
Cardiac Devices CRT,ICD: Who is and is not a Candidate? Who Decides
Cardiac Devices CRT,ICD: Who is and is not a Candidate? Who Decides Colette Seifer MB(Hons) FRCP(UK) Associate Professor, University of Manitoba, Cardiologist, Cardiac Sciences Program, St Boniface Hospital
Large RCT s of CRT 2002 to present
Have We Expanded Our Use of CRT for Heart Failure Patients? Sana M. Al-Khatib, MD, MHS Associate Professor of Medicine Electrophysiology Section- Division of Cardiology Duke University Potential Conflicts
Cardiac Resynchronization Therapy Guidelines and Missing Groups
Cardiac Resynchronization Therapy Guidelines and Missing Groups Frank Pelosi, Jr., MD, FACC, FHRS Director, Cardiac Electrophysiology Fellowship Associate Professor of Medicine University of Michigan Health
Arthur J. Moss, MD Professor of Medicine/Cardiology University of Rochester Medical Center Rochester, NY. DISCLOSURE INFORMATION Arthur J.
Saving Lives and Preventing Heart Failure: The MADIT Family of Trials Arthur J. Moss, MD Professor of Medicine/Cardiology University of Rochester Medical Center Rochester, NY Update in Electrocardiography
Implantation of a CRT-Pacemaker Rather than CRT-Defibrillator is Usually Preferred
Implantation of a CRT-Pacemaker Rather than CRT-Defibrillator is Usually Preferred Professor John GF Cleland University of Hull Kingston-upon-Hull United Kingdom Conflict of Interest: Funding or Speakers
All in the Past? Win K. Shen, MD Mayo Clinic Arizona Controversies and Advances in CV Diseases Cedars-Sinai Heart Institute, MFMER
ICD for NICM All in the Past? Win K. Shen, MD Mayo Clinic Arizona Controversies and Advances in CV Diseases Cedars-Sinai Heart Institute, 2017 2017 MFMER 3686275-1 DISCLOSURE Relevant Financial Relationship(s)
Implantable Cardioverter- Defibrillators (ICDs) for the Prevention of SCD: Appropriate Use in Disclosures
Implantable Cardioverter- Defibrillators (ICDs) for the Prevention of SCD: Appropriate Use in 2015 Andrew E. Epstein, MD Professor of Medicine, Cardiovascular Division University of Pennsylvania Chief,
Workingman s Guide to CRT Indications: Making Sense of the Various Guidelines
Workingman s Guide to CRT Indications: Making Sense of the Various Guidelines Andrew E. Epstein, MD Professor of Medicine, Cardiovascular Division University of Pennsylvania Chief, Cardiology Section Philadelphia
Comparison of clinical trials evaluating cardiac resynchronization therapy in mild to moderate heart failure
HOT TOPIC Cardiology Journal 2010, Vol. 17, No. 6, pp. 543 548 Copyright 2010 Via Medica ISSN 1897 5593 Comparison of clinical trials evaluating cardiac resynchronization therapy in mild to moderate heart
Risk Stratification of Sudden Cardiac Death
Risk Stratification of Sudden Cardiac Death Michael R Gold, MD, PhD Medical University of South Carolina Charleston, SC USA Disclosures: None Sudden Cardiac Death A Major Public Health Problem > 1/2 of
Implantable Cardioverter Defibrillator Therapy in MADIT II Patients with Signs and Symptoms of Heart Failure
Implantable Cardioverter Defibrillator Therapy in MADIT II Patients with Signs and Symptoms of Heart Failure Wojciech Zareba Postinfarction patients with left ventricular dysfunction are at increased risk
Dialysis-Dependent Cardiomyopathy Patients Demonstrate Poor Survival Despite Reverse Remodeling With Cardiac Resynchronization Therapy
Dialysis-Dependent Cardiomyopathy Patients Demonstrate Poor Survival Despite Reverse Remodeling With Cardiac Resynchronization Therapy Evan Adelstein, MD, FHRS John Gorcsan III, MD Samir Saba, MD, FHRS
Importance of CRT team for optimization of the results: a European point of view
Importance of CRT team for optimization of the results: a European point of view Matteo Bertini, MD, PhD Arcispedale S. Anna Azienda Ospedaliero-Universitaria Cona-Ferrara No conflict of interest to declare
ICD Therapy. Disclaimers
ICD Therapy Rodney Horton, MD Texas Cardiac Arrhythmia Institute Texas Cardiovascular, PA Austin, TX Speaker s Bureau St. Jude Medical Medtronic Boston Scientific Disclaimers Clinical Advisory Panel St.
ESC Stockholm Arrhythmias & pacing
ESC Stockholm 2010 Take Home Messages for Practitioners Arrhythmias & pacing Prof. Panos E. Vardas Professor of Cardiology Heraklion University Hospital Crete, Greece Disclosures Small teaching fees from
Endpoints When Treating VT/VF in Patients with ICDs Programming Wojciech Zareba, MD, PhD
Endpoints When Treating VT/VF in Patients with ICDs Programming Wojciech Zareba, MD, PhD Professor of Cardiology/Medicine Director of the Heart Research Follow Up Program, University of Rochester, Rochester,
Preventing Sudden Death Current & Future Role of ICD Therapy
Preventing Sudden Death Current & Future Role of ICD Therapy Derek V Exner, MD, MPH, FRCPC, FACC, FAHA, FHRS Professor, Libin Cardiovascular Institute of Alberta Canada Research Chair, Cardiovascular Clinical
La stimulation biventriculaire (Traitement par Resynchronisation Cardiaque) Indications et Résultats. Daniel Gras, DIU, Paris 2007
La stimulation biventriculaire (Traitement par Resynchronisation Cardiaque) Indications et Résultats, DIU, Paris 2007 CRT: Results and indications Background Results of CRT Studies Today s classical CRT
Do All Patients With An ICD Indication Need A BiV Pacing Device?
Do All Patients With An ICD Indication Need A BiV Pacing Device? Muhammad A. Hammouda, MD Electrophysiology Laboratory Department of Critical Care Medicine Cairo University Etiology and Pathophysiology
Device based CRT optimization: is there a future? Lessons learned from published trials
Device based CRT optimization: is there a future? Lessons learned from published trials C. Leclercq Department of Cardiology Centre Cardio-Pneumologique Rennes, France Presenter Disclosure Information
CRT-D or CRT-P: HOW TO CHOOSE THE RIGHT PATIENT?
CRT-D or CRT-P: HOW TO CHOOSE THE RIGHT PATIENT? Alessandro Lipari, MD Chair and Department of Cardiology University of Study and Spedali Civili Brescia -Italy The birth of CRT in Europe, 20 years ago
ICD Guidelines: who benefits from an ICD?
ICD Guidelines: who benefits from an ICD? Matthew Bennett Cardiac Electrophysiologist Vancouver Coastal Health, Device Lead Associate Professor, UBC Matthew.bennett@vch.ca Disclosures I have research collaborations
Who does not need a primary preventive ICD?
Who does not need a primary preventive ICD? Hildegard Tanner, Bern Universitätsklinik für Kardiologie Disclosure of potential conflicts of interest Travel grants for educational purposes from: Biosense
Left Ventricular Ejection Fraction >35%
Controversies in Cardiac Resynchronisation Therapy Left Ventricular Ejection Fraction >35% Professor John GF Cleland University of Hull Kingston-upon-Hull United Kingdom Conflict of Interest: I have received
Cardiac Resynchronization ICD Therapy: What is New?
Cardiac Resynchronization ICD Therapy: What is New? Emile Daoud, MD Section Chief, Cardiac Electrophysiology Professor of Medicine The Ohio State University Normal Activation, Narrow QRS Synchrony Abnormal
BSH Annual Autumn Meeting 2017
BSH Annual Autumn Meeting 2017 Presentation title: The Development of CRT Speaker: John GF Cleland Conflicts of interest: I have received research support and honoraria from Biotronik, Boston Scientific,
Device Based Therapy for the Failing Heart: ICD and Cardiac Resynchronization Rx
Device Based Therapy for the Failing Heart: ICD and Cardiac Resynchronization Rx Charles Gottlieb, MD Director of Electrophysiology Abington Memorial Hospital Heart Failure Mortality Mechanism of death
Implantable cardioverter-defibrillators and cardiac resynchronization therapy
Implantable cardioverter-defibrillators and cardiac resynchronization therapy Johannes Holzmeister, MD University Hospital Zurich, Zurich, Switzerland Frontiers of heart failure controversies, ESC - Paris
MADIT Studies: CRT in the Non-LBBB Patient and Other Findings. Arthur J. Moss, MD
MADIT Studies: CRT in the Non-LBBB Patient and Other Findings Arthur J. Moss, MD University of Rochester Medical Cntr. Rochester, NY 13 th Annual New Frontiers in Heart Failure Rx NYC, NY January 26, 2013
How do I convert my CRT Non Responder into Responder?
How do I convert my CRT Non Responder into Responder? Michael R Gold, MD, PhD Medical University of South Carolina Charleston, SC Disclosures: Clinical Trials and Consulting Boston Scientific, Medtronic
Atrial fibrillation and mortality: where is the missing link? Isabelle C Van Gelder University Medical Center Groningen
Atrial fibrillation and mortality: where is the missing link? Isabelle C Van Gelder The Netherlands Madrid Europace June 2011 Conflict of interests Research grants from Medtronic, SJM, Biotronik, Boston,
IMPLANTABLE DEVICE THERAPY FOR HEART FAILURE
IMPLANTABLE DEVICE THERAPY FOR HEART FAILURE Nora Goldschlager, M.D. MACP, FACC, FAHA, FHRS Cardiology San Francisco General Hospital UCSF Disclosures: None LEADING CAUSES OF DEATH IN US Sudden cardiac
Shock Reduction Strategies Michael Geist E. Wolfson MC
Shock Reduction Strategies Michael Geist E. Wolfson MC Shock Therapy Thanks, I needed that! Why Do We Need To Reduce Shocks Long-term outcome after ICD and CRT implantation and influence of remote device
This is What I do to Improve CRT Response for CRT Non-Responders
This is What I do to Improve CRT Response for CRT Non-Responders Michael R Gold, MD, PhD Medical University of South Carolina Charleston, SC Disclosures: Steering Committees (unpaid) and Clinical Trials,
CT Academy of Family Physicians Scientific Symposium October 2012 Amit Pursnani, MD
CT Academy of Family Physicians Scientific Symposium October 2012 Amit Pursnani, MD Clinical syndrome resulting from a structural or functional cardiac disorder that impairs the ability of the heart to
First question: Does CRT Work in AF?
CRT in AF Does it work and when to ablate AF versus AV node Maurizio Gasparini Chief EP and Pacing Unit Humanitas Research Hospital, Rozzano - Milano, Italy First question: Does CRT Work in AF? As any
Heart failure and sudden death
Heart failure and sudden death What did we learn so far from important ICD- and CRT trials? Helmut U. Klein M.D. University of Rochester Medical Center Heart Research Follow up Program Arrhythmic substrate
Fibrillazione atriale e scompenso: come interrompere il circolo vizioso.
Alessandria, September 23 th 2017 Fibrillazione atriale e scompenso: come interrompere il circolo vizioso. Professor Fiorenzo Gaita Chief of the Cardiovascular Department Città della Salute e della Scienza
Device Interrogation- Pacemakers, ICD and Loop Recorders. Dulce Obias-Manno, RN, MHSA, CCDS,CEPS, FHRS Device Clinic Coordinator, MHVI
Device Interrogation- Pacemakers, ICD and Loop Recorders Dulce Obias-Manno, RN, MHSA, CCDS,CEPS, FHRS Device Clinic Coordinator, MHVI Disclosures Consultant: Medtronic Speaker s Bureau: St. Jude Medical
Response of Right Ventricular Size to Treatment with Cardiac Resynchronization Therapy and the Risk of Ventricular Tachyarrhythmias in MADIT-CRT
Response of Right Ventricular Size to Treatment with Cardiac Resynchronization Therapy and the Risk of Ventricular Tachyarrhythmias in MADIT-CRT Heart Rhythm Society (May 11, 2012) Colin L. Doyle, BA,*
Should ICD Replacement Be Performed in Octogenarians and/or Severe Comorbidities?
Should ICD Replacement Be Performed in Octogenarians and/or Severe Comorbidities? JC Daubert Rennes, France Disclosure 2008-2011 Medical devices Speaker Consultant Trial committees EBR + + Impulse Dynamics
Atrial Fibrillation and Heart Failure
Date Clinical Title Atrial Fibrillation and Heart Failure Raul Weiss MD, FAHA, FACC, FHRS and CCDS Director, Electrophysiology Fellowship Program Professor of Medicine The Ohio State University Wexner
Continuous ECG telemonitoring with implantable devices: the expected clinical benefits
Continuous ECG telemonitoring with implantable devices: the expected clinical benefits C. W. Israel, M.D. Dept. of Cardiology Evangelical Hospital Bielefeld Germany Carsten.Israel@evkb.de Declaration of
CRT-P or CRT-D From North Alberta to Nairobi
CRT-P or CRT-D From North Alberta to Nairobi Dr Mzee Ngunga Aga Khan University Hospital Nairobi KCS Congress: Impact through collaboration CONTACT: Tel. +254 735 833 803 Email: kcardiacs@gmail.com Web:
Integration of diagnostic device information to improve patient management
Integration of diagnostic device information to improve patient management Haran Burri Associate Professor Cardiology Service University Hospital of Geneva Disclosures Biotronik: fellowship support, speaker
Cardiac Resynchronization Therapy. Michelle Khoo, MD
Cardiac Resynchronization Therapy Michelle Khoo, MD 10.7.08 HuiKuri HV NEJM 2001 Sudden Death (SD) in Subset Populations HuiKuri HV NEJM 2001 Sudden Death (SD) in Subset Populations SD in Competitive Athletes
Provocative Cases: Issues in the Expanding Use of CRT in Treating CHF Patients
Provocative Cases: Issues in the Expanding Use of CRT in Treating CHF Patients David E. Krummen, MD Associate Professor of Medicine University of California San Diego and VA San Diego Healthcare System
Device Therapy for Heart Failure
Device Therapy for Heart Failure Dr. Shelley Zieroth FRCPC Assistant Professor, Cardiology, University of Manitoba Director of Cardiac Transplant and Heart Failure Clinics St Boniface General Hospital,
Understanding and Development of New Therapies for Heart Failure - Lessons from Recent Clinical Trials -
Understanding and Development of New Therapies for Heart Failure - Lessons from Recent Clinical Trials - Clinical trials Evidence-based medicine, clinical practice Impact upon Understanding pathophysiology
I NON RESPONDERS ALLA CRT: UN PROBLEMA DI NON SEMPLICE SOLUZIONE
I NON RESPONDERS ALLA CRT: UN PROBLEMA DI NON SEMPLICE SOLUZIONE Gaetano Senatore S.C. CARDIOLOGIA OSPEDALE DI CIRIE & OSPEDALE DI IVREA LABORATORIO di Today s Patient Selection for CRT +AF and PM patients
Bi-Ventricular pacing after the most recent studies
Seminars of the Hellenic Working Groups February 18th-20 20,, 2010, Thessaloniki, Greece Bi-Ventricular pacing after the most recent studies Maurizio Lunati MD Director EP Lab & Unit Cardiology Dpt. Niguarda
Atrial Fibrillation Ablation in Patients with Heart Failure
Atrial Fibrillation Ablation in Patients with Heart Failure Eleftherios M. Kallergis, MD, PhD, FESC Cardiology Department, Heraklion University Hospital Since auricular fibrillation so often complicates
BENEFIT OF CRT IN MILDLY SYMPTOMATIC HEART FAILURE RECENT DATA FROM MADIT-CRT AND RAFT
BENEFIT OF CRT IN MILDLY SYMPTOMATIC HEART FAILURE RECENT DATA FROM MADIT-CRT AND RAFT Ilan Goldenberg MD Professor of Cardiology Sheba Medical Center and Tel Aviv University, Israel University of Rochester
Beta-blockers in heart failure: evidence put into practice
Beta-blockers in heart failure: evidence put into practice John McMurray Professor of Medical Cardiology, University of Glasgow & Consultant Cardiologist,Western Infirmary, Glasgow, UK Eugene Braunwald
How Do I Balance Bradycardia with Rate Control in Atrial Fibrillation?
How Do I Balance Bradycardia with Rate Control in Atrial Fibrillation? Thang Nguyen MD FRCPC Assistant Professor Section of Cardiology Department of Internal Medicine University of Manitoba Objectives
The Role of ACEI and ARBs in AF prevention
The Role of ACEI and ARBs in AF prevention Dr. Sameh Shaheen MD, FESC Prof. of cardiology Ain-Shams university Time course of atrial substrate remodeling in relation to the clinical appearance of AF and
Scompenso cardiaco e F A : ruolo della ablazione transcatetere. Prof. Fiorenzo Gaita
Scompenso cardiaco e F A : ruolo della ablazione transcatetere Prof. Fiorenzo Gaita Patients with atrial fibrillation (%) Prevalence of AF in HF Trials 60 50 30% NYHA III-IV NYHA IV 40 NYHA II-III 30 20
MADIT-RIT: Simple programming change averts most inappropriate ICD therapy
Print MADIT-RIT: Simple programming change averts most inappropriate ICD therapy NOV 6, 2012 Steve Stiles Los Angeles, CA - A large randomized trial has identified specific programming criteria for implantable
Cardiac resynchronization therapy for mild-to-moderate heart failure
For reprint orders, please contact reprints@expert-reviews.com Cardiac resynchronization therapy for mild-to-moderate heart failure Expert Rev. Med. Devices 8(3), 313 317 (2011) Haran Burri Electrophysiology
Primary prevention ICD recipients: the need for defibrillator back-up after an event-free first battery service-life
Chapter 3 Primary prevention ICD recipients: the need for defibrillator back-up after an event-free first battery service-life Guido H. van Welsenes, MS, Johannes B. van Rees, MD, Joep Thijssen, MD, Serge
Resynchronization/Defibrillation
Resynchronization/Defibrillation for Ambulatory Heart Failure Trial Cardiac Resynchronization Therapy for Mild to Moderate Heart Failure George Wells University of Ottawa Heart Institute Department of
Interventional solutions for atrial fibrillation in patients with heart failure
Interventional solutions for atrial fibrillation in patients with heart failure Advances in Cardiovascular Arrhythmias Great Innovations in Cardiology Matteo Anselmino, MD PhD Division of Cardiology Department
CRT: whom does it benefit?
CRT: whom does it benefit? Francisco Leyva BSH Revalidation and Training 2018 Queen Elizabeth Hospital NICE guidelines for CRT LVEF 35% NYHA class I II III IV QRS
ESC Guidelines for the Diagnosis and Treatment of Chronic Heart Failure
ESC Guidelines for the Diagnosis and Treatment of Chronic Heart Failure - 2005 Karl Swedberg Professor of Medicine Department of Medicine Sahlgrenska University Hospital/Östra Göteborg University Göteborg
A patient with decompensated HF
A patient with decompensated HF Professor Michel KOMAJDA University Pierre & Marie Curie Pitie Salpetriere Hospital Department of Cardiology Paris (France) Declaration Of Interest 2010 Speaker : Servier,
Treatment of Atrial Fibrillation in Heart Failure
Stockholm, September 1st 2010 Treatment of Atrial Fibrillation in Heart Failure Rhythm control: Which drugs? Stefan H. Hohnloser J.W. Goethe University Frankfurt, Germany Presenter disclosure information:
Role of Ablation of AF and PVCs in the Management of Heart Failure
Role of Ablation of AF and PVCs in the Management of Heart Failure Cara Pellegrini, MD, FHRS Acting Chief, Cardiology, SF VA Associate Professor of Medicine, UCSF Disclosures I have nothing to disclose
علم االنسان ما لم يعلم
In the name of Allah, the Beneficiate, the Merciful ق ال هللا تعالي: 5 الدى علم بالق لم 4 علم االنسان ما لم يعلم سورة العلق It is He (Allah), Who has taught by the pen He has taught man which he did not
How atrial fibrillation should be treated in the heart failure patient?
Advances in Cardiac Arrhhythmias and Great Innovations in Cardiology Torino, 13/15 Ottobre 2016 How atrial fibrillation should be treated in the heart failure patient? Matteo Anselmino Dipartimento Scienze
ESC Guidelines. ESC Guidelines Update For internal training purpose. European Heart Journal, doi: /eurheart/ehn309
ESC Guidelines Update 2008 ESC Guidelines Heart failure update 2008 For internal training purpose. 0 Agenda Introduction Classes of recommendations Level of evidence Treatment algorithm Changes to ESC
Heart Failure Management. Waleed AlHabeeb, MD, MHA Assistant Professor of Medicine Consultant Heart Failure Cardiologist
Heart Failure Management Waleed AlHabeeb, MD, MHA Assistant Professor of Medicine Consultant Heart Failure Cardiologist Heart failure prevalence is expected to continue to increase¹ 21 MILLION ADULTS WORLDWIDE
Heart Failure in Women
Heart Failure in Women Disclosure Professor Sindone has received honoraria, speaker fees, consultancy fees, is a member of advisory boards or has appeared on expert panels for: Professor Andrew Sindone
New Strategies For Treating Patients With Chronic Heart Failure
New Strategies For Treating Patients With Chronic Heart Failure Barry Greenberg MD Professor of Medicine Director, Advanced Heart Failure Treatment Program University of California, San Diego Disclosures
Indications for and Prediction of Successful Responses of CRT for Patients with Heart Failure
Indications for and Prediction of Successful Responses of CRT for Patients with Heart Failure Edmund Keung, MD Clinical Chief, Cardiology Section San Francisco VAMC October 25, 2008 Presentation Outline
Heart Failure Treatments
Heart Failure Treatments Past & Present www.philippelefevre.com Background Background Chronic heart failure Drugs Mechanical Electrical Background Chronic heart failure Drugs Mechanical Electrical Sudden
ICD and SCD prevention in Europe How to better prevent Sudden Cardiac Death in the future ICD and beyond
ICD and SCD prevention in Europe How to better prevent Sudden Cardiac Death in the future ICD and beyond K.-H. Kuck Asklepios Klinik St. Georg Hamburg, Germany Disclosure Statement Research Grants Consultant
Cardiac resynchronization therapy for heart failure: state of the art
Cardiac resynchronization therapy for heart failure: state of the art Béla Merkely MD, PhD, DSc, FESC, FACC Vice president of the European Society of Cardiology Honorary president of the Hungarian Society
Gender and cardiac resynchronization therapy. Chairs: David Heaven & Belinda Green. Gender and Cardiac Resynchronisation Therapy
Electrophysiology Gender and cardiac resynchronization therapy Dean Boddington Chairs: David Heaven & Belinda Green Gender and Cardiac Resynchronisation Therapy Dean Boddington Tauranga Hospital 1 Disclosure/Warning
ICD THERAPIES: are they harmful or just high risk markers?
ICD THERAPIES: are they harmful or just high risk markers? Konstantinos P. Letsas, MD, PhD, FESC LAB OF CARDIAC ELECTROPHYSIOLOGY EVANGELISMOS GENERAL HOSPITAL ATHENS ICD therapies are common In a meta-analysis
Therapeutic Targets and Interventions
Therapeutic Targets and Interventions Ali Valika, MD, FACC Advanced Heart Failure and Pulmonary Hypertension Advocate Medical Group Midwest Heart Foundation Disclosures: 1. Novartis: Speaker Honorarium
Atrial Fibrillation Ablation in Patients with Heart Failure
Atrial Fibrillation Ablation in Patients with Heart Failure Eleftherios M. Kallergis, MD, PhD, FESC Cardiology Department, Heraklion University Hospital Since auricular fibrillation so often complicates
Atrial Fibrillation and Heart Failure: Rate vs. Rhythm Control Time for Re-evaluation
Atrial Fibrillation and Heart Failure: Rate vs. Rhythm Control Time for Re-evaluation ANIL K. BHANDARI, M.D, Director, Electrophysiology and EPS Fellowship Program Good Samaritan Hospital/ Harbor UCLA
Biventricular Pacemakers (Cardiac Resynchronization Therapy) for the Treatment of Heart Failure
Biventricular Pacemakers (Cardiac Resynchronization Therapy for the Treatment of Heart Failure 2.02.10 Biventricular Pacemakers (Cardiac Resynchronization Therapy for the Treatment of Heart Failure Policy
HF-PEF: Symptoms, quality of life and mortality/morbidity
HF-PEF: Symptoms, quality of life and mortality/morbidity May 21, 2011 John McMurray, MD Eugene Braunwald Scholar in Cardiovascular Diseases, Brigham & Women s Hospital Boston; Visiting Professor of Medicine,
Ενδείξεισ εμφύτευςησ απινιδωτή ςτην «γκρίζα ζώνη» Γεώργιοσ Ανδρικόπουλοσ, MD, PhD, Αν. Δ/ντήσ Καρδιολογικήσ Κλινικήσ ΓΝΑ «Ερρίκοσ Ντυνάν»
Ενδείξεισ εμφύτευςησ απινιδωτή ςτην «γκρίζα ζώνη» Γεώργιοσ Ανδρικόπουλοσ, MD, PhD, Αν. Δ/ντήσ Καρδιολογικήσ Κλινικήσ ΓΝΑ «Ερρίκοσ Ντυνάν» Major Implantable Cardioverter-Defibrillator Trials for Prevention
14ο Βορειοελλαδικό Καρδιολογικό Συνέδριο ΚΕΒΕ Βηματοδότηση: Νεότερες εξελίξεις Προοπτικές
14ο Βορειοελλαδικό Καρδιολογικό Συνέδριο ΚΕΒΕ Βηματοδότηση: Νεότερες εξελίξεις Προοπτικές Α.Γ. Κατσίβας Συντονιστής Διευθυντής, Α Καρδιολογική Κλινική, ΓΝΑ «Κοργιαλένειο-Μπενάκειο Ε.Ε.Σ» BRADY - ARRHYTHMIA
עדכונים באלקטרופיזיולוגיה Electrophysiology Unit Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev
עדכונים באלקטרופיזיולוגיה 2014 Electrophysiology Unit Soroka University Medical Center Faculty of Health Sciences Ben-Gurion University of the Negev 1 מבנה הצגת היחידה פעילות ביחידה סקירה על הטיפול באלקטרופיזיולוגיה
Where Does the Wearable Cardioverter Defibrillator (WCD) Fit In?
Where Does the Wearable Cardioverter Defibrillator (WCD) Fit In? 24 th Annual San Diego Heart Failure Symposium June 1-2, 2018 La Jolla, CA Barry Greenberg, MD Distinguished Professor of Medicine Director,
Risk prediction in inherited conditions Laminopathies
Risk prediction in inherited conditions Laminopathies Karim Wahbi Cochin hospital, Paris karim.wahbi@aphp.fr Risk prediction in laminopathies Current approach for risk stratification A new score to predict
Role of Non-Implantable Defibrillators in the Management of Patients at High Risk for Sudden Cardiac Death
Role of Non-Implantable Defibrillators in the Management of Patients at High Risk for Sudden Cardiac Death 29 October 2011 Update in Electrocardiography and Arrhythmias Zian H. Tseng, M.D., M.A.S. Associate
Disclosures: Drs. Bristow, Saxon, Boehmer, Kass, and Feldman are consultants to Guidant (sponsor) HFSA Late-Breaker September 24, 2003
Cardiac Resynchronization Therapy (CRT) Reduces Hospitalizations, and CRT with Implantable Defibrillator (CRT-D) Reduces Mortality in Chronic Heart Failure: The COMPANION Trial Bristow MR,(Co-Ch) Feldman
Subcutaneous Implantable Cardioverter Defibrillator (S-ICD)
Subcutaneous Implantable Cardioverter Defibrillator (S-ICD) D. D. MANOLATOS, MD, PhD, FESC Electrophysiology and Device Lab General Hospital Evangelismos, Athens The Problem: 300,000 people die each year
Current guidelines for device-based therapy of cardiac
Long-Term Benefit of Primary Prevention With an Implantable Cardioverter-Defibrillator An Extended 8-Year Follow-Up Study of the Multicenter Automatic Defibrillator Implantation Trial II Ilan Goldenberg,
Follow-up of CRT patients ESC Munich Clinical and biological follow-up of CRT patients
Follow-up of CRT patients ESC Munich 12-08-26 Clinical and biological follow-up of CRT patients Frieder Braunschweig MD PhD FESC Associate Professor of Cardiology Karolinska University Hospital Stockholm,
Polypharmacy - arrhythmic risks in patients with heart failure
Influencing sudden cardiac death by pharmacotherapy Polypharmacy - arrhythmic risks in patients with heart failure Professor Dan Atar Head, Dept. of Cardiology Oslo University Hospital Ullevål Norway 27.8.2012
C h a p t e r 15. Benefit of combined resynchronization and defibrillator therapy in heart failure patients with and without ventricular arrhythmias
C h a p t e r 15 Benefit of combined resynchronization and defibrillator therapy in heart failure patients with and without ventricular arrhythmias Claudia Ypenburg Lieselot van Erven Gabe B. Bleeker Jeroen