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Maija Vikmane defended her Doctoral Thesis “Assessment of Factors Determining Efficacy of Cardiac Resynchronisation Therapy for Patients with Heart Failure in the Population of Latvia” on 27 January at a public session of the Doctoral Council of Medicine of Rīga Stradiņš University (RSU).

Heart failure is caused by structural or functional damage to the heart, as a result of which the function of the heart chambers deteriorates so that full blood circulation and tissue metabolism are not ensured. This significantly affects a patient's quality of life and increases the risk of life-threatening arrhythmias.

Heart failure is mainly treated with medications, however occasionally this fails to prevent uncoordinated ventricular contractions. In such cases, cardiac resynchronisation devices are used in addition to medications to help restore proper coordination between atria and heart ventricles and ensure coordinated contraction of both ventricles.

A study on the use of resynchronisation devices was carried out for the first time in Latvia to understand the situation in the country and to evaluate their efficacy, as well as to identify the possible reasons for their inefficiency.

In the world, medical treatments have been accompanied by cardiac resynchronisation devices for over a decade. The first device was implanted in 2006 in Latvia. This study was conducted from 2009 to 2012 as the implantation rate in Latvia grew.

50 patients were enrolled in the clinical trial. All of them were implanted with cardiac resynchronisation devices. The patients’ subjective and objective feelings were evaluated prior to implantation, and 12 and 24 months after. It was concluded that high efficacy of cardiac resynchronisation therapy was achieved in nearly two-thirds of the cases within two years.

The study concludes that implantation of cardiac resynchronisation devices is a safe and efficient method of treating heart failure. The device significantly improves a patient’s quality of life statistically, by significantly reducing the number of re-hospitalisations, for example. No device-related complications, or adverse cardiovascular events, like myocardial infarctions, were observed during the study.

The author developed a table of the potential efficiency of cardiac resynchronisation devices. This can be used as selection criteria for selecting patients for implantations, as well as to predict the efficiency of their performance.

Scientific supervisors: RSU Prof. Oskars Kalējs and RSU Prof. Aivars Lejnieks

The doctoral thesis was carried out with the financial support of the “Support for doctoral study programmes and the acquisition of a scientific degree at Rīga Stradiņš University” project of the European Social Fund.