In some patients, the normal, systematic, sequential connection, the contraction of the ventricles is disturbed (he is dyssynchron). Dyssynchrony may be,
The need to treat an arrhythmia depends on the symptoms and the risks inherent in this arrhythmia in itself. The therapy is based on the reasons behind any particular arrhythmia. If necessary, a direct antiarrhythmic therapy with anti-arrhythmic drugs, cardioversion, defibrillation, implantable cardioverter-defibrillators (ICDs), pacemaker (and a special form of “pacing”, cardiac resynchronization therapy), or a combination of these forms of treatment may be necessary. In some patients, the normal, systematic, sequential connection, the contraction of the ventricles is disturbed (he is dyssynchron). Dyssynchrony may atrioventricular: between atrial and ventricular contraction Interventrikulär: between left and right ventricular intraventricular: between the different segments of left ventricular contraction patients at risk for dyssynchrony among others, the following symptoms are: Ischemic or non-ischemic dilated cardiomyopathy Prolonged QRS interval (? 130 ms) Left ventricular end diastolic diameter ? 55 mm in left ventricular ejection fraction ? 35% sinus rhythm cardiac resynchronization therapy (CRT) involves the use of a pacing system in order to synchronize the heart’s contraction. Such systems generally comprise an electrode in the right atrium, the right ventricle and the left ventricle. Electrodes can be placed transvenous or surgically via thoracotomy. In patients with symptoms of heart failure in New York Heart Association (NYHA) class II, III, or IV, the CRT can reduce the likelihood of hospitalization for heart failure and the overall mortality. However, it has little or no benefit in patients with permanent atrial fibrillation, right bundle branch block, nonspecific intraventricular conduction defect or only slight prolongation of QRS duration (<150 ms).