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Summary
Cardiac resynchronization therapy (CRT) using biventricular pacing has become standard of care therapy for patients with symptomatic heart failure, wide QRS and left ventricular ejection fraction (LV-EF) < 35% refractory to optimal medical treatment. Tremendous data has demonstrated improvement in quality of life as well as mortality rates in CRT responders. However individual long-term response is difficult to predict as demonstrated by the usual 25-30% rate of non-responders.
Permanent His bundle pacing (HBP) has emerged as an alternative to biventricular pacing to deliver physiologic pacing as well as cardiac resynchronization.
We are presenting the case of a 78-year-old patient in whom resynchronization using His bundle pacing translated into a clearly superior acute electrical result compared to biventricular pacing.
The sodium-glucose co-transporter 2 inhibitors have become an integral part of the treatment of patients with high cardiovascular risk or established cardiovascular disease. In the present review, we summarize the available data from pre-clinical and human studies on the mechanisms underlying the beneficial effects of sodium-glucose co-transporter 2 inhibitors in patients with cardiac dysfunction and heart failure, we discuss the data from clinical trials on the prevention and treatment of heart failure, and we present the recommendation of the most recent international guidelines regarding the use of sodium-glucose co-transporter 2 inhibitors in this context.
