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The dynamics of changes of leads' technical parameters during stimulation
Kulík, Tomáš ; Chmelař, Milan (referee) ; Rozman, Jiří (advisor)
The main theme of the thesis is the dynamics of changes of leads’ technical parameters during stimulation. The thesis is dealt with statistical analysis of clinical dates and investigation of time variability of chosen stimulation parameters during the time of implantation to 3 years after surgical intervention. The document consists of theoretical parts about cardiac pacing and one’s own project of statistical solution according to submission.
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Software Tools for the Analysis of Cardiac Depolarization in Patients with Heart Failure
Smíšek, Radovan ; Richter, Aleš (referee) ; Nováková, Marie (referee) ; Kolářová, Jana (advisor)
Heart failure is a disease in which the heart cannot adequately supply the body with oxygenated blood. Approximately 2% of people in the developed world have heart failure, which is increasing. Cardiac resynchronization therapy, which involves the implantation of a biventricular pacemaker, is used in patients with ventricular dyssynchrony to suppress or at least reduce the symptoms of heart failure. The problem is that 30–50% of patients do not benefit from performed resynchronization therapy. The correct patient selection and the pacemaker implantation and set-up method influence the success rate. The thesis proposes methodologies and software to facilitate the selection of patients suitable for cardiac resynchronization therapy, select the correct pacing lead placement, and optimize pacemaker settings. The developed software is based on standard parameters used in clinical practice (QRS duration, presence of left bundle branch block, classification of heart rhythm) and, in addition, on the analysis of ultra-high-frequency ECG, which provides more detailed information on cardiac activation than the standard parameters used. The developed software helps patients in 16 hospitals in the Czech Republic and abroad.
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Pathophysiological and clinical aspects of cardiac dyssynchrony in children and adolescents
Kovanda, Jan ; Janoušek, Jan (advisor) ; Bulava, Alan (referee) ; Klásková, Eva (referee)
Pathophysiological and clinical aspects of cardiac dyssynchrony in children and adolescents Electromechanical dyssynchrony is an important factor in the development of heart failure. It is caused by abnormal activation of the working myocardium in case of bundle branch block or ventricular pacing. Asymmetric hypertrophy of the affected ventricle develops together with its dilatation and reduced function and fulfils the picture of dyssynchronous cardiomyopathy. The development of dyssynchronopathy can be prevented by careful selection of the permanent pacing site and treated by cardiac resynchronization therapy. One of the aims of this work was to compare clinical and echocardiographic findings in patients paced from the left-ventricular apex with the healthy population. Using a retrospective cross-sectional study, we have proved that left ventricular function is not adversely affected in long-term follow-up. Another aim of the study was to evaluate the long-term results of resynchronization therapy of the systemic ventricle in patients with congenital heart defects. Using a retrospective study, we have described an acceptable long-term survival at the price of relatively frequent complications. We were extensively working on a new method of resynchronization of the right subpulmonary ventricle in...
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Development of cardiovascular system function in patients with a functionally single ventricle
Materna, Ondřej ; Janoušek, Jan (advisor) ; Klásková, Eva (referee) ; Urbanová, Zuzana (referee)
Development of cardiovascular system function in patients with a functionally single ventricle. Abstract Total cavopulmonary connection (TCPC) is the only possible surgical palliative procedure in patients with a functionally single ventricle. It consists of the stepwise anastomosis of both caval veins with pulmonary arteries, creating a unique situation of so-called Fontan circulation, where the separation of the pulmonary and systemic circuit is traded for chronically elevated systemic venous pressure and impaired cardiac output increase during exercise. We aimed to evaluate long-term results and development of exercise capacity in the population of patients with TCPC in the Czech Republic, possible predictors of their survival and functional outcome, as well as analysis of permanent cardiac resynchronization as one of the new treatment options for dysfunction of the single ventricle. We present a retrospective study of all consecutive patients in the Czech Republic identified in the nationwide single-centre institutional database and matched with the National Death Registry and Cardiovascular Intervention Registries. We proved that overall mean survival probability until composite end-point of death, TCPC take- down or indication for a heart transplant was 92.9 % at 20 years after the operation. TCPC...
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The dynamics of changes of leads' technical parameters during stimulation
Kulík, Tomáš ; Chmelař, Milan (referee) ; Rozman, Jiří (advisor)
The main theme of the thesis is the dynamics of changes of leads’ technical parameters during stimulation. The thesis is dealt with statistical analysis of clinical dates and investigation of time variability of chosen stimulation parameters during the time of implantation to 3 years after surgical intervention. The document consists of theoretical parts about cardiac pacing and one’s own project of statistical solution according to submission.
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