Public Defence: Stian Balnagown Ross
Cand.med. Stian Balnagown Ross at Institute of Clinical Medicine will be defending the thesis “Cardiac resynchronization therapy - Acute response parameters” for the degree of PhD (Philosophiae Doctor).
Trial Lecture – time and place
See Trial Lecture.
- First opponent: Professor Jens Cosedis Nielsen, Department of Cardiology, Aarhus University Hospital, Denmark
- Second opponent: Associate Professor Hanne Bjørnstad, Nordlandssykehuset
- Third member and chair of the evaluation committee: Associate Professor Are Martin Holm, Faculty of Medicine, University of Oslo
Chair of the Defence
Professor Emeritus Odd Geiran, Faculty of Medicine, University of Oslo
Head of Section Erik Kongsgård, Oslo University Hospital
Heart failure patients need individualized therapy and are recommended treatment with a biventricular pacemaker if prolonged QRS duration co-exists. However, one third will not benefit from this treatment called cardiac resynchronization therapy (CRT). Response is normally validated after 6 months. The overall aim of the thesis was to investigate feasibility and predictive capability of novel acute CRT response parameters.
Both electrical and mechanical parameters were assessed in this project and compared to the acute hemodynamic response to CRT under device implantation. We observed that a premature septal contraction pattern assessed using echocardiography might be an excellent marker of acute hemodynamic response to CRT.
In a standard CRT implantation, a lateral position of the left ventricular lead is recommended. This region may, however, not always be accessible. We found that pacing induced changes in a 3D ECG had good predictive capability of the acute CRT response in patients with a non-lateral left ventricular position.
The pacemaker leads positions move when the heart contracts and we hypothesized that the motion of the pacemaker leads could provide mechanical information used to estimate contractility. We extracted contractile surrogates from a 3D continuous interlead distance between the right and left ventricular lead. The results were disappointing, and non of the contractile surrogates were able to predict acute CRT response.
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