Cardiac Resynchronization Therapy: From Epigenetic to Social Networks

Celestino Sardu, MD (Editor)
Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University Study of Naples, Naples, Italy

Series: Cardiology Research and Clinical Developments
BISAC: MED010000

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Over the last few decades, cardiac resynchronization therapy (CRT) has been introduced as a choice treatment for heart failure (HF) patients, refractory to maximal drug therapy and left bundle branch block. Advanced heart failure is related to cardiac fibrosis, hypertrophy and apoptosis, and CRT in 30% of patients is not able to ameliorate cardiac performance and mechanical efficiency. This clear loss of effect (CRT failure) is frustrating and leaves HF patients in a steady and/or advanced, uncontrolled worsening state of clinical symptoms and NYHA class.

Several hypotheses have been conducted to explain this loss of effect: investigating epigenetic (microRNAs activation pattern), echocardiography (mechanical cardiac dyssynchrony assessment), arrhythmias (atrial fibrillating patients), left ventricle lead positioning (target wall and vessel) and pacing modalities (bipolar vs multipolar), and epicardial approaches (cardiac surgery) to reach the target ventricular wall. The selection criteria, the implant technique and CRT monitoring are relevant aspects of the “CRT world” in all its complexity. The necessity to follow and characterize CRT recipients (responders vs non responders), and the routine follow up with recent advancements in technology (telemonitoring) may be an instrument to improve CRT response entity and clinical outcomes. The creation of a social platform (social networks) may represent a necessary and evolutionary step to share individual experiences and to exchange ideas about CRT recipients and experienced operators. The opportunity to improve CRT responders’ percentage may represent a gold standard and an attractive prospective in failing heart patients CRT recipients. In this book, we have investigated these aspects, hoping to provide to the reader the right reading tools in the CRT world. Our message remains: To help people suffering from cardiovascular diseases and to live better with their disease. (Imprint: Nova Biomedical)

Preface

Chapter 1. Epigenetic Modulation in Heart Failure (HF) Patients Treated by a Cardiac Resynchronization Therapy with a Defibrillator (CRT-d)
Celestino Sardu, Giuseppe Paolisso, Raffaele Marfella, and Maria Rosaria Rizzo (Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University Study of Naples, Naples, Italy)

Chapter 2. Advances in Cardiac Resynchronization Therapy (CRT) Pacing Mode: Multipolar Left Ventricle Lead Stimulation Technology
Quintino Parisi, Matteo Santamaria, Loredana Messano, Andrea A. Papa, and Celestino Sardu (Department of Cardiovascular Diseases, John Paul II Research and Care Foundation, Campobasso, Italy, and others)

Chapter 3. Atrial Fibrillation and Cardiac Resynchronization Therapy (CRT) in Heart Failure Patients
Matteo Santamaria, Quintino Parisi, Loredana Messano, Stefania Funaro, and Celestino Sardu (Cardiovascular Diseases Department, John Paul II Research and Care Foundation, Campobasso, Italy, and others)

Chapter 4. Cardio Thoracic Surgery Approach to Cardiac Resynchronization Therapy: Implant Techniques, Advantages and Limitations
Nicola Testa, Paola Spatuzza, Carlo Maria De Filippo, and Celestino Sardu (Cardiovascular Department, John Paul II, Research and Care Foundation, Campobasso, Italy, and others)

Chapter 5. Echocardiographic Assessment of Cardiac Dyssynchrony: Advances in Methodology
Stefania Funaro, Matteo Santamaria, Quintino Parisi, Marina Florio, Loredana Messano, Daniele Colaprete, Nicola Ferri, Vincenzo Ienco, Cosimo Sacra, and Celestino Sardu (Cardiovascular Diseases Department, John Paul II Research and Care Foundation, Campobasso, Italy, and others)

Chapter 6. How to Monitor Cardiac Resynchronization Therapy (CRT) Recipients: The Remote Monitoring (RM) System
Celestino Sardu, Quintino Parisi, Antonio Fiorentino, Antonio Russo, Loredana Messano, and Matteo Santamaria (Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, Second University Study of Naples, Naples, Italy, and others)

Chapter 7. Social Network Impact on Cardiac Resynchronization Therapy (CRT) Recipients: A New Window in Heart Diseases World
Celestino Sardu, Mauro di Marino, Quintino Parisi, Loredana Messano, and Matteo Santamaria (Department of Medical, Surgical, Neurological, Metabolic and Aging Sciences, University of Naples, Naples, Italy, and others)

Index

This book is written for patients, medicine students, biomedical enginery students, nursing, and professionals involved in medical care, and all doctors with expertise in cardiovascular diseases, cardiac surgery and cardiac arrhythmias. It will appeal for people of industries involved in CRT-d devices design, construction and programming.

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