Resynchronization & Advanced Cardiac Therapeutics

Overview

Physicians within the Resynchronization and Advanced Cardiac Therapeutics Program treat patients with heart failure who have diminished heart function and need special pacemaker therapy to synchronize the pumping action of the heart.

This program works through the collaborative efforts of the Heart Failure and Cardiac Transplant Program, the Cardiac Arrhythmia Service and echocardiography services at the Massachusetts General Hospital Corrigan Minehan Heart Center. We also work closely with referring primary cardiologists or internists to ensure continuity of care for patients.

About this Program

The Resynchronization and Advanced Cardiac Therapeutics Program was established in November of 2005 to provide multidisciplinary care to heart failure patients eligible for device therapy. Care is provided through the collaborative effort and expertise of echocardiography, electrophysiology and heart failure specialists. The program uses research and evidence-based medicine to provide cutting-edge treatment options to patients.

Our Vision

Some of the important objectives of the program are to:

• Enhance the extent of benefit that patients receive from cardiac resynchronization therapy
• Provide integrated and multidisciplinary care to enhance and improve clinical outcomes
• Identify patients who might not show adequate responses in a timely fashion and prevent an exacerbation of their heart failure
• Provide remote monitoring of devices, which enable early intervention and prevent hospitalizations

Our goal is to deliver state-of-the-art device therapy to improve the quality of life of our patients.

Treatments and Procedures

Most patients are seen for three to four visits to maximize treatment therapies. Our specialists offer a variety of treatments and procedures including:

• An evaluation of cardiac resynchronization therapy candidates by specialists in heart failure, electrophysiology and echocardiography
• Cardiac resynchronization therapy device implantation
• A post-implant evaluation by a team of doctors and nurses, designed to individualize treatment strategies for our patients
• Patient education
• Device interrogations
• Echocardiography-guided device optimization and follow-up care
• Home or remote-monitoring and follow-up care
• Opportunities for patients to participate in cutting-edge treatment strategies

Coordinating the Beating of the Heart

Cardiac resynchronization therapy is provided for patients with heart failure due to an abnormality in the pumping of the heart's ventricles. The heart's ventricles are supposed to contract simultaneously, but in many patients with heart failure, they may beat out of synchrony.

Care within the Resynchronization and Advanced Cardiac Therapeutics Program truly has no boundaries. Our specialists care for patients in inpatient, outpatient and emergency room settings, as well as follow them remotely in their homes. Bluetooth and radiofrequency (RF) capabilities are typically used in coordination with defibrillator and cardiac resynchronization therapy.

Benefits of Cardiac Resynchronization Therapy

Our physicians have found that cardiac resynchronization therapy can offer patients a number of benefits. Some of these benefits include:

• Improved quality of life
• Increased exercise capacity
• Reduction in hospitalization for heart failure
• Reduction in mortality rates

Cardiac resynchronization therapy involves the placement of an implantable biventricular pacing device with three leads (right atrial, right ventricular and left ventricular) that synchronize ventricular contractions. The result is a more efficient heart, and more importantly, a better quality of life for our patients.

This proactive approach saves lives by alerting patients and physicians often before symptoms occur. They receive detailed information on how the heart is beating and can call a patient into the hospital if there is a medical emergency.

A Leader in Research

Specialists within the Resynchronization and Advanced Cardiac Therapeutics Program have a significant role in several national and international multicenter studies. We have advanced the field of device therapy by:

• Improving patient selection and predicting response to cardiac resynchronization therapy. Our work has led to the creation of a novel response score to predict clinical outcomes in this patient group
• Advancing and developing novel ventricular lead implantation strategies. We have used novel rotational venography and imaging techniques to propose and substantiate new coronary venous anatomy classification and to redefine the best views for lead implantation
• Developing novel image integration strategies for cardiac resynchronization therapy. Our physicians have done innovative work integrating computed tomography, ultrasound and fluoroscopy to create better clinical strategies to facilitate device implantation and patient follow up
• Using device diagnostics and remote monitoring in heart failure patients. Our physicians are leaders in using device diagnostics and remote monitoring technology. Recent work from our investigators has resulted in the creation of a predictive algorithm for patient response and long-term outcome

We are currently seeking participants for the following clinical trials:

Seeking subjects with hypertrophic cardiomyopathy - HCM - (healthy subjects needed)

Do you have heart disease?

Seeking Patients with Heart Failure