Heart Disease - Top 10 Advances of the Millenium (well,
so far)
6) Resynchronization therapy for heart failure
In a normal ventricle, the electrical conducting system delivers the electrical impulse to the left ventricle in a highly coordinated manner. As a result, the organized pattern of contraction squeezes (or wrings) the blood out of the ventricle very efficiently. In many patients with dilated cardiomyopathy, however, this electrical coordination is lost. The resultant dis-coordination leads to an exaggerated fall in the ventricular ejection fraction (that is, a drop in ejection fraction over and above that which would be caused by the weakened heart muscle itself.)
At least two pacemaker manufacturers are evaluating new pacemaker devices that help to re-coordinate ventricular contraction in patients with dilated cardiomyopathy. These devices pace both the left and right ventricles simultaneously (whereas normal pacemakers pace the right ventricle alone), an action that has the effect of resynchronizing the muscle contraction in the left ventricle, and thus improving the efficiency of the weakened heart.
Data reported on resynchronization therapy in the year 2000 has made it clear that a substantial proportion of patients with dilated cardiomyopathy can be materially benefited by such therapy. Many patients experienced a dramatic improvement in exercise tolerance and in quality of life with resynchronization therapy, and studies are ongoing to measure whether such therapy improves overall survival.
Based on the data reported during Y2K, it is highly likely that resynchronization devices will gain FDA approval sometime in 2001. Patients with dilated cardiomyopathy should begin asking their doctors to monitor the availability of resynchronization therapy.
Next page
What do you think? Enter the Heart Disease Forum:
