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Electrophysiology of Heart Failure and Cardiac Resynchronization Therapy

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Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care

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Abstract

Besides heart rate, contractility, preload, and afterload, mechanical atrioventricular (AV) and inter- and intraventricular synchrony are major determinants of cardiac output and cardiac contraction efficiency. Intraventricular electromechanical dyssynchrony, as caused by an electrical activation delay, may lead to dyssynchronous heart failure accompanied by significant structural and cellular remodeling. Electrical retiming of the heart using temporary or permanent cardiac resynchronization pacing (CRT) has been used both to acutely manipulate cardiac output in the postoperative setting as well as to chronically treat dyssynchronous heart failure. CRT has been shown to improve cardiac function in both adults and children and to induce reverse ventricular and myocardial cellular remodeling. In large randomized adult trials, CRT also decreased heart failure-related morbidity and improved overall survival. Although published evidence on CRT efficacy in children lags behind studies on adult patients with idiopathic and ischemic cardiomyopathy, principal effects seem to be the same. This chapter summarizes the knowledge on the electrophysiology of heart failure as well as on temporary and permanent cardiac resynchronization pacing in children.

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Acknowledgments

The author was supported by the Agency for Medical Research, Ministry of Health of the Czech Republic (grant no. 15-28029A), and by the project (Ministry of Health, Czech Republic) for conceptual development of research organization 00064203 (University Hospital Motol, Prague, Czech Republic).

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Authors and Affiliations

  1. Children’s Heart Center, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic

    Jan Janoušek

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  1. Jan Janoušek
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Correspondence to Jan Janoušek .

Editor information

Editors and Affiliations

  1. Children’s Hospital Colorado University of Colorado Denver, School of, Aurora, CO, USA

    Eduardo M. da Cruz

  2. Children's Hospital Colorado University of Colorado School of Medicin, Aurora, CO, USA

    Dunbar Ivy

  3. Department of Cardiac Surgery, German Pediatric Heart Center, Sankt Augustin, Germany

    Viktor Hraska

  4. Pediatric Cardiac Surgery, Children's Hospital Colorado University of Colorado, Aurora, CO, USA

    James Jaggers

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  1. No affiliation provided

    Kathryn K. Collins

  2. No affiliation provided

    Dustin Nash

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Janoušek, J. (2023). Electrophysiology of Heart Failure and Cardiac Resynchronization Therapy. In: da Cruz, E.M., Ivy, D., Hraska, V., Jaggers, J. (eds) Pediatric and Congenital Cardiology, Cardiac Surgery and Intensive Care. Springer, London. https://doi.org/10.1007/978-1-4471-4999-6_141-2

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  • DOI: https://doi.org/10.1007/978-1-4471-4999-6_141-2

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  • Print ISBN: 978-1-4471-4999-6

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