Cardiac Resynchronization Therapy on heart failure patients - new implantation techniques

Prof. Dr. Béla Merkely was born in 1966 in Budapest; he graduated from Semmelweis University in Hungary in1991. He had 2 years of experimental and clinical cardiology research at Heidelberg University, and then started to work at the Department of Cardiovascular Surgery of Semmelweis University in 1993. He earned his board certificatein internal medicine in 1996, then in cardiology in 1998. He was the first Hungarian cardiologist to earn the EHRA “Cardiac Pacing” accreditation in 2007. He earned a PhD degree in 1999 and a DSc (Doctor of Hungarian Academy of Science) degree in 2006. He is currently Director and Professor of the Heart Center of Semmelweis University, chairman of the Cardiology Graduate Education. His areas of clinical expertise are cardiac electrophysiology, device therapy and interventional cardiology. In addition to his chairmanship and active participation ingraduate and postgraduate cardiology education, he is the program director of the PhD School for cardiovascular research. He is the chief editor of the Hungarian Journal of Physician Education and an editorial board member of several international journals. He is the President Elect ofthe Hungarian Society of Cardiology.

Abstract

Cardiac resynchronization therapy (CRT) with biventricular stimulation has become the treatment of choice in patients with severe congestive heart failure and intraventricular conduction delay in the last decade. It decreases mortality, morbidity and improves quality of life foreligible patients. However, about 30% of patients still do not respond to treatment. Currently the focus of research is to optimize patient selection and therapy utilization to increase efficacy and cost-effectiveness of CRT. The Heart Center of Semmelweis University is a majo relectrophysiological center performing more than 250 CRT device implantations each year. Research is a major focus at this Institute and had several significant contributions to this field, such as single-lead CRT, optimization with MRI, fixation of the left ventricular lead with the useof coronary stents, minimally invasive lead repositioning or CRT after cardiac transplantation. Despite the convincing evidence on the efficacy of CRT, this therapeutic method is still under-utilized in most countries. In addition to basic and clinical research aiming at therapy optimization, the number of implantations should be increased to provide more benefit to patients with severe congestive heart failure and intraventricular block.