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

Authors: Avanesyan G.A., Filatov A.G., Yakhyaev Ya.B., Smaznov F.V., Shalov R.Z.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, Russian Federation

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Type:  Original articles


DOI: https://doi.org/10.24022/1997-3187-2025-19-2-217-228

For citation: Avanesyan G.A., Filatov A.G., Yakhyaev Ya.B., Smaznov F.V., Shalov R.Z. Personalized approach in the selection and treatment of patients with chronic heart failure using cardiac resynchronization therapy with or without atrial fibrillation/ Creative Cardiology. 2025; 19 (2): 217–228 (in Russ.). DOI: 10.24022/1997-3187-2025-19-2-217-228

Received / Accepted:  12.02.2025 / 27.02.2025

Keywords: chronic heart failure resynchronization therapy



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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.

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About Authors

  • Grayr A. Avanesyan, Cand. Med. Sci., Researcher; ORCID
  • Andrey G. Filatov, Dr. Med. Sci., Head of the Department of X-ray Surgical and Intraoperative Diagnosis and Treatment of Arrhythmias; ORCID
  • Yakhya B. Yakhyaev, Cardiovascular Surgeon; ORCID
  • Fedor V. Smaznov, Resident Physician; ORCID
  • Ruslan Z. Shalov, Cand. Med. Sci., Junior Researcher; ORCID

Chief Editor

Elena Z. Golukhova, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery


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