Download - Devices and intervention in heart failure
LV Remodeling Post MI and Heart Failure
• Parachute: Ventricular Restoration– Partitions the damaged muscle and reduces heart
wall stress– Decreases LV volume and restores geometrical
shape– Improves cardiac performance
Speaker
1Jhund and McMurray. Heart Failure After Acute MI. Circulation. 2008;118:2019-2021
2RESTORE Group. JACC 2004, Vol. 44, No. 7.
Baroreflex Activation Therapy (BAT)Application
• Stimulate bilaterally (2nd gen unilaterally) carotid bodies
Hypothesis: BAT mimics increased BP resulting in inhibition of sympathetic activity and enhanced parasympathetic activity
• Clinical data suggest BAT reduces muscle sympathetic nerve activity and improves HRV
Evidence
Carotid sinusmechanoreceptors
Carotid sinusnerves
Brainstemcardiovascular
centers
Ach Ach
PACE Primary Endpoints
LV e
ject
ion
frac
tion
(%)
*P<0.001 vs. baseline, †P<0.05 vs. 1-year follow-up
Absolute difference of EF by 7%Absolute difference of EF by 7% at 1-year, and at 1-year, and 9.9% at 2-year9.9% at 2-year
RVA pacingRVA pacing
BiV pacing
LV e
nd-s
ysto
lic v
olum
e (m
l)*P<0.001 vs. baseline, †P<0.05 vs. 1-year follow-up
Absolute difference of LVESV by 8.1ml Absolute difference of LVESV by 8.1ml at 1-year, at 1-year, and 13.0 ml at 2-yearand 13.0 ml at 2-year
EF LVESV
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