His bundle pacing is a relatively new method of cardiac pacing. This method is used in patients with atrioventricular block to prevent heart failure associated with right ventricular pacing, and in patients with bundle branch block and cardiomyopathy. We report a patient with cardiomyopathy and left bundle branch block with failure of cardiac resynchronization therapy. Permanent His bundle pacing was associated with clinical improvement and improvement of parameters of cardiac function.

• Klíčová slova
• His bundle pacing, cardiac resynchronization therapy, cardiomyopathy, heart failure, left bundle branch block, left ventricular ejection fraction,
• MeSH
• blokáda Tawarova raménka diagnóza   etiologie   patofyziologie   chirurgie   MeSH
• dilatační kardiomyopatie komplikace   diagnóza   patofyziologie   chirurgie   MeSH
• elektrokardiografie MeSH
• funkce levé komory srdeční fyziologie   MeSH
• Hisův svazek fyziologie   MeSH
• implantované elektrody MeSH
• kardiostimulace umělá metody   MeSH
• kardiostimulátor MeSH
• lidé MeSH
• senioři MeSH
• srdeční katetrizace přístrojové vybavení   metody   MeSH
• srdeční resynchronizační terapie škodlivé účinky   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

INTRODUCTION: The aim of this study was to investigate the predictors of long-term clinical outcome of heart failure (HF) patients who survived first year after initiation of cardiac resynchronization therapy (CRT). METHODS: This was a single-center observational cohort study of CRT patients implanted because of symptomatic HF with reduced ejection fraction between 2005 and 2013. Left ventricle (LV) diameters and ejection fraction, New York Heart Association (NYHA) class, and level of N-terminal fragment of pro-brain natriuretic peptide (NT-proBNP) were assessed at baseline and 12 months after CRT implantation. Their predictive power for long-term HF hospitalization and mortality, and cardiac and all-cause mortality was investigated. RESULTS: A total of 315 patients with left bundle branch block or intraventricular conduction delay who survived >1 year after CRT implantation were analyzed in the current study. During a follow-up period of 4.8±2.1 years from CRT implantation, 35.2% patients died from cardiac (19.3%) or non-cardiac (15.9%) causes. Post-CRT LV ejection fraction and LV end-systolic diameter (either 12-month value or the change from baseline) were equally predictive for clinical events. For NT-proBNP, however, the 12-month level was a stronger predictor than the change from baseline. Both reverse LV remodeling and 12-month level of NT-proBNP were independent and comparable predictors of CRT-related clinical outcome, while NT-proBNP response had the strongest association with all-cause mortality. When post-CRT relative change of LV end-systolic diameter and 12-month level of NT-proBNP (dichotomized at -12.3% and 1230 ng/L, respectively) were combined, subgroups of very-high and very-low risk patients were identified. CONCLUSION: The level of NT-proBNP and reverse LV remodeling at one year after CRT are independent and complementary predictors of future clinical events. Their combination may help to improve the risk stratification of CRT patients.

• MeSH
• biologické markery MeSH
• časové faktory MeSH
• funkční vyšetření srdce MeSH
• lidé středního věku MeSH
• lidé MeSH
• natriuretický peptid typu B metabolismus   MeSH
• pooperační období MeSH
• prognóza MeSH
• remodelace komor * MeSH
• ROC křivka MeSH
• senioři MeSH
• srdeční resynchronizační terapie škodlivé účinky   metody   MeSH
• srdeční selhání metabolismus   mortalita   patologie   terapie   MeSH
• výsledek terapie MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• biologické markery MeSH
• natriuretický peptid typu B MeSH