Medicine review
Episode 2
Cardiac release and colonization therapy or CRT, the general principles are patient cardiomyopathy, have electrolyte, mechanical, TB, with dysentrony and the dysentrony, ventral right and left, leads to lower stroke volume and lower cardiac output, includes also results in more MR, eye-filling, pressures, worse, functional status, more hospitalizations and more death. Dysentrony tends to correspond to abnormal QIRs on ECG, CRT also paces the RV and our LB to re-synchronize, so to say, and then platform options include CRT-D, which is pacing and defibrillation, CRT-P, which is pacing only. CRT has been shown to use heart failure symptoms and hospitalizations and deaths, then there's also one-third approval that applies, so the response is pretty good in one-third, not so good in one-third and one-third remain, more or less the same, no change. So the slam-dank indications of CRT include the patient should be in silence rhythm, symptoms include NYJ class 2, 2 ambulatory class 4, on goal-direction medical therapy, huge expression should be less than 35%, typical LBB or left under branch block QRS of more than 130. Then there are some weak indications where the patient does not have LBB and also has um, just fresh and still low, and on goal-direction medical therapy with QRS of more than 150, and then there are margin current candidates which are patients who are on permanent atrial fibrillation, patients who require chronic RV pacing and symptomatic heart failure with rejection fraction. So the addition of ICD therapy is appropriate if ICD indications are independently met.