Personalized approach in the selection and treatment of patients with chronic heart failure using cardiac resynchronization therapy with or without atrial fibrillation

DOI: https://doi.org/10.24022/1997-3187-2025-19-2-217-228
Keywords: chronic heart failure, resynchronization therapy

Abstract

The aim of the study is to evaluate the effectiveness of a personalized approach in the selection and correction of patients with chronic heart failure (CHF) by implantation of cardiac resynchronization therapy (CRT) with or without atrial fibrillation.

Material and methods. The study involved 80 patients with CHF (mean age 66 ± 4.2 years) who met the following criteria: complete left bundle branch block (QRS ≥ 135 ms), low left ventricular ejection fraction (< 40%), and no valve defects requiring surgical correction. Patients were divided into two groups of 40 people.

In the first group, resynchronization therapy was performed using a standard device setting based on the duration of the QRS complex.

In the second group, device settings were performed taking into account echocardiography data, including an assessment of mechanical dyssynchrony and functional parameters of the left ventricle.

Results. The analysis showed positive changes in both groups, but in the second group, where echocardiography data were used, the results were significantly better.

Conclusion. The use of echocardiography data to personalize the settings of CRT devices demonstrated a significant improvement in the electrical and mechanical functions of the heart. In the second group, a more pronounced reduction in the duration of the QRS complex and an increase in the ejection fraction were observed, indicating the advantage of a personalized approach. Setting up CRT taking into account echocardiography improves the prognosis of patients with CHF and emphasizes the need to introduce modern imaging methods into clinical practice. These data confirm the feasibility of using personalized approaches to improve the effectiveness of treatment for this category of patients.

Author Biographies

Grayr A. Avanesyan, Bakoulev National Medical Research Center for Cardiovascular Surgery

Cand. Med. Sci., Researche

Andrey G. Filatov, Bakoulev National Medical Research Center for Cardiovascular Surgery

Dr. Med. Sci., Head of the Department of X-ray Surgical and Intraoperative Diagnosis and Treatment of Arrhythmias

Ya.B. Yakhyaev, Bakoulev National Medical Research Center for Cardiovascular Surgery

Cardiovascular Surgeon

F.V. Smaznov, Bakoulev National Medical Research Center for Cardiovascular Surgery

Resident Physician

 

Ruslan Z. Shalov, Bakoulev National Medical Research Center for Cardiovascular Surgery

Cand. Med. Sci., Junior Researcher

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Published
2025-07-30
Issue
Vol. 19 No. 2 (2025): Creative Cardiology
Section
Оригинальные статьи