Relation between Coronary Sinus O2 Saturation and Response to Cardiac Resynchronization Therapy in Patients with Severe Heart Failure

Akbarzadeh, Fariborz; Tabrizi, Mehrnoosh Tofan; Arbat, Babak Kazemi; Naseralavi, Fahemeh
December 2013
Medical Journal of Tabriz University of Medical Sciences & Healt;Dec2013/Jan2014, Vol. 35 Issue 5, p12
Academic Journal
Backgrounds and Objectives: Congestive Heart Failure (CHF) is a prevalent disease and has a great economic impact on health systems. Cardiac Resynchronization Therapy (CRT), which synchronize biventricular contraction, is one of the most important therapies in these patients. Despite the exact selection of patients about 30% of patients do not respond to CRT. The aim of this study was to evaluate the O2 saturation and the pressure level of right side of heart and Coronary Sinus (CS) vein to predict the response to CRT. Materials and Methods: In this descriptive study, 30 patients were candidate for implantation of CRT echocardiography. The 6 Minute Walk Test (6MW), right side and CS O2 saturation and pressure study was done before implantation. Echocardiography and 6MW repeated 6 months later. Based on response to the CRT, patients were divided into two groups: "responder and non-responder". Date were compared between groups. Results: O2 saturation was significantly lower in responders than non-responders. In non-responder patients the Right Ventricular (RV) and Pulmonary Artery (PA) Pressure was significantly higher than responders. Desaturation of CS blood flow in responders was probably due to higher levels of viable tissue which involve in contraction. Increase in right side and PA pressure in non-responders might be due to severity of heart failure which made CRT not effective in these patients. Conclusion: Evaluation of O2 saturation of CS blood flow, RV and PA pressure can use as an index in predicting the response to CRT and can help as additional indices in selection of patients with borderline indications for implanting CRT.


Related Articles

  • Interventricular and intra-left ventricular electromechanical delays in right ventricular paced patients with heart failure: implications for upgrading to biventricular stimulation. Bordachar P; Garrigue S; Lafitte S; Reuter S; Ja''s P; Ha''ssaguerre M; Clementy J // Heart;Dec2003, Vol. 89 Issue 12, p1401 

    OBJECTIVE: To correlate, in patients with right ventricular pacing (RVP), the QRS width with electromechanical variables assessed by pulsed Doppler tissue imaging echocardiography. Secondly, to find reliable parameters for selecting RVP patients who would respond to biventricular pacing (BVP)....

  • Ehokardiografska procena akutnog hemodinamskog odgovora tokom optimizacije resinhronizacionog pejsmejkera korišćenjem različitih modaliteta pejsinga i atrioventrikularnog kaÅ¡njenja. Martinović, Sonja Šalinger; Perišić, Zoran; Milić, Dragan; Apostolović, Svetlana; Tomašević, Miloje; Kostić, Tomislav; Božinović, Nenad; Stanojević, Dragana // Vojnosanitetski Pregled: Military Medical & Pharmaceutical Journ;May2009, Vol. 66 Issue 5, p365 

    Background/Aim. Cardiac resynchronization therapy (CRT) improves ventricular dyssynchrony and is associated with an improvement in symptoms, quality of life and prognosis in patients with severe heart failure and intraventricular conduction delay. Different pacing modalities produce variable...

  • 829 Baseline left ventricular asynchrony predicts long-term benefit of resynchronisation therapy. Romito, R.; Iacoviello, M.; Greco, S.; Luzzi, G.; Guida, P.; De Tommasi, E.; Rizzon, B.; Rizzon, P.; Pitzalis, M. V. // European Journal of Echocardiography;2003, Vol. 4 Issue suppl_1, pS142 

    An abstract of the article "Baseline left ventricular asynchrony predicts long-term benefit of resynchronisation therapy" by R. Romito and colleagues is presented.

  • Bifocal right ventricular pacing: an alternative way to achieve resynchronization when left ventricular lead insertion is unsuccessful. Sideris, Skevos; Aggeli, Constantina; Poulidakis, Emmanouil; Gatzoulis, Kostas; Vlaseros, Ioannis; Avgeropoulou, Katerina; Felekos, Ioannis; Sotiropoulos, Ilias; Stefanadis, Christodoulos; Kallikazaros, Ioannis // Journal of Interventional Cardiac Electrophysiology;Oct2012, Vol. 35 Issue 1, p85 

    Purpose: Bifocal pacing in the right ventricle is an option for patients with end-stage heart failure in whom biventricular pacing is not possible, due to failure in left ventricular (LV) lead insertion. The purpose of this prospective study was to document the clinical response of these...

  • Contribution to the V-V Interval Optimization in Patients with Cardiac Resynchronization Therapy. Novák, M.; Lipoldová, J.; Meluzín, J.; Krejčí, J.; Hude, P.; Feitová, V.; Dušk, L.; Kamarýt, P.; Vitovec, J. // Physiological Research;2008, Vol. 57 Issue 5, p693 

    The present study proposed procedure for predicting an optimal left and right ventricular pacing interval delay (V-V interval). In 16 patients (heart failure, left bundle branch block, biventricular pacing) two methods (A and B) identifying optimal V-V interval were tested. Method A: predicted...

  • Clinical Relevance Of Systematic CRT Device Optimization. Lunati, Maurizio; Magenta, Giovanni; Cattafi, Giuseppe; Moreo, Antonella; Falaschi, Giacomo; Contardi, Danilo; Locati, Emanuela // JAFIB: Journal of Atrial Fibrillation;Aug/Sep2014, Vol. 7 Issue 2, p62 

    Cardiac Resynchronization Therapy (CRT) is known as a highly effective therapy in advanced heart failure patients with cardiac dyssynchrony. However, still one third of patients do not respond (or sub-optimally respond) to CRT. Among the many contributors for the high rate of non-responders, the...

  • Native QRS narrowing reflects electrical reversal and associates with anatomical reversal in cardiac resynchronization therapy. Yang, Xin-wei; Hua, Wei; Wang, Jing; Liu, Zhi-min; Ding, Li-gang; Chen, Ke-ping; Zhang, Shu // Journal of Interventional Cardiac Electrophysiology;Nov2014, Vol. 41 Issue 2, p161 

    Purpose: Abbreviation of paced QRS duration has been taken as electrical resynchronization imposed by cardiac resynchronization therapy (CRT). However, little is known about alteration in native QRS duration and its correlation with therapeutic response as well as anatomical remodeling post-CRT....

  • ALSYNC: Alternate site benefited patients with HF needing CRT.  // Cardiology Today;Jun2014, Vol. 17 Issue 6, p22 

    The article reports on the benefits of a novel atrial transseptal system for the patients with heart failure (HF) who need cardiac resynchronization therapy (CRT) but fail to receive it.

  • PERSPECTIVE. Russo, Andrea M. // Cardiology Today;Jun2014, Vol. 17 Issue 6, p23 

    The author discusses the benefits of a novel atrial transseptal system for the patients with heart failure (HF) who need cardiac resynchronization therapy (CRT) but fail to receive it.


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics