Transthoracic impedance cardiography to promote clinical and functional improvement in patients with heart failure submitted to cardiac resynchronization therapy

• Grant number: 11/06881-3
• Support Opportunities: Regular Research Grants
• Start date: August 01, 2011
• End date: July 31, 2014
• Field of knowledge: Health Sciences - Medicine - Medical Clinics
• Principal Investigator: Martino Martinelli Filho
• Grantee: Martino Martinelli Filho
• Host Institution: Instituto do Coração Professor Euryclides de Jesus Zerbini (INCOR). Hospital das Clínicas da Faculdade de Medicina da USP (HCFMUSP). Secretaria da Saúde (São Paulo - Estado). São Paulo , SP, Brazil
• Associated researchers: Anísio Alexandre Andrade Pedrosa ; Giselle de Lima Peixoto ; Ricardo Alkmim Teixeira ; Sérgio Freitas de Siqueira ; Silvana Angelina D'Orio Nishioka ; Thacila Regina Mozzaquatro

Abstract

Patients with heart failure (HF) refractory to conventional treatment have been submitted to Cardiac Resynchronization Therapy (CRT). Today, we face the difficulties and costs for programming optimization. Transthoracic impedance cardiography (Cardio Z) may be a promising alternative method for atrioventricular (AV) and interventricular (VV) optimization, especially in non-responders to CRT (about 30%). This study will consist of two protocols: Protocol A: 150 patients submitted to TRC at least for 3 months (group I = responders to TRC and group II = non-responders). In group I we will perform adjustments in AV and VV intervals, however in group II there will no interventions. Protocol B: will be included 60 consecutive patients with CRT indication. After implantation, they will be randomized to optmization by echocardiographic (group I), by Cardio Z (grupo II) or no optmization (grupo III). The goals are: Protocol A: 1. To evaluate the impact of eletronic optimization by Cardio Z in non-responders; 2. To compare the electronic programming of the responders to CRT with the programming of non-responders, as proposed by Cardio Z; 3. To evaluate the functional changes of patients optimized by Cardio Z. Protocol B: 1. To compare the rate of response to CRT optimized by Cardio Z with optimization by echocardiography; 2. To evaluate the impact of optimization methods on the rate of hospitalization for HF. Thus, we can assess the impact of Cardio Z in CRT optimization on daily routine. (AU)