Suppression of Acute Heart Failure Rehospitalization by Biventricular Pacing in Wide QRS and Mid-Range Ejection Fraction

Figures

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  Figure 1. (A) 12‐lead electrocardiogram (ECG) before cardiac resynchronization therapy (CRT). (B) Radial (2‐D) strain with speckle‐tracking echocardiography in the short‐axis view at the papillary muscle. The colour cording of the strain curves refers to the respective left ventricular segments. (C) Exercise stress‐induced QRS widening and (D) exacerbation of LV dyssynchrony during stress echocardiography.

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  Figure 2. Waveform recording of the intra‐left ventricular pressure and the pulmonary capillary wedge pressure (PCWP) and simultaneous echocardiography before CRT implantation. (A) PCWP, left ventricular end‐diastolic pressure (LVEDP) and pulmonary arterial V‐wave augmentation were massively augmented by phenylephrine infusion. (B) Trivial mitral regurgitation (MR) progressed to severe MR with phenylephrine infusion.

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  Figure 3. (A) 12‐lead ECG before cardiac resynchronization therapy (CRT). (B) Attenuation of dyssynchrony with CRT, and (C) no remarkable worsening of dyssynchrony during stress echocardiography in radial (2‐D) strain on speckle‐tracking echocardiography.

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  Figure 4. Waveform recording of the intra‐left ventricular pressure and the PCWP and simultaneous echocardiography after CRT implantation. (A) Phenylephrine‐induced augmentation of PCWP, LVEDP and pulmonary arterial V‐wave were obviously attenuated. (B) MR worsening was not observed even after infusion of phenylephrine.