Cardiac dyssynchrony : structural, functional, transcriptional and pharmacological aspects

One-quarter of patients with heart failure suffer from a conduction disorder resulting in an impaired cardiac contractility and function. Pacemakers improving their prognosis and reducing their symptoms (so-called cardiac resynchronisation therapy or CTR) are not effective in one-third of these patients. In an attempt to understand the underlying mechanism, Van Middendorp discovered a biomarker that might predict the effects of CRT and the treatment of dyssynchronous heart failure. He also showed that antiarrhythmic drugs should be used even more carefully in people with heart failure who also suffer from a conduction disorder. Furthermore, he showed that Vernakalant, a new antiarrhythmic drug that had initially received a positive evaluation, reduced the pumping ability of the heart to the same extent as the conventional antiarrhythmic drug Flecainide.This study was partially funded by the Dutch Heart Foundation