Journal club

52 yo F with CHF NYHAIII, she is on Bisoprolol 10 mg, Entresto 97/103 mg BID, torsemide 20 mg daily. TTE all chamber dilation, LVEF 25%, EKG sinus rhythm, HR72, complete LBBB, what is the next treatment option?

• Heart transplant

• CRT implantation

• CRT-D implantation

• ICD implantation

• LVAD

Tags

NGSS.HS-ETS1-3

What is not an indication of CRT ?

• QRS > 150

• CHF NYHA II-IV despite Max tolerated GDMT

• Paroxysmal, recurrent A fib

• LVEF < 35%

78 yo f, FU for HFrEF diagnosed 6 months ago, NYHA III, on entresto, spiro, lasix, SCLT2, BB. On exam BP 104/62, HR 58. EKG sinus rhythm, LBBB QRS 155, TTE EF 30%, LVED dimensions 3mm, mod. MR, and mild AS. what is the best ttt?

 

• CRT

• Ivabradine

• TAVR

• Transcatheter edge to edge MV repair

The main use of CRT-D is ?

 

• Same as standard pacemaker only in young patients

• Same as standard pacemaker only in elderly patients

• is only applied at A fib in the presence of brady systole

• Heart failure ttt method

Indications of CRT in symptomatic heart failure includes all except

• LVEF < 35%

• QRS > 150

• LBBB

• LVED diameter > 58 mm

74 yo F, evaluated for DOE, PMH of ICCM, x3 hospitalizations for CHF exacerbation in 6 M, Colon Cancer 2 yrs, treated with no recur. She has ICD, on lisinopril, empagliflozin, lasix, spironolactone, she stopped BB, and Imdur for hypotension. BP 94/66, HR 88, S3, creatinine 1.7 Na 132, LVEF10%, best next ttt ?

• Heart transplant

• Hospitalization

• LVAD

• low dose BB