Objective: Cardiac resynchronization therapy has been used in the treatment of advanced heart failure with inter- and intraventricular dyssynchrony for more than ten years.
Aim Of The Study: A retrospective study was conducted to assess midterm results of biventricular (BiV) pacing in cardiac resynchronization therapy.
Methods: 128 consecutive patients (age 61.0+/-9.6, 98 males), with heart failure NYHA class 2.9+/-0.4 (2.5-3.5), with LBBB, QRS> or =130 ms, with dilated cardiomyopathy--DCM (86), with coronary artery disease--CAD (36), with both these etiologies (4) and with valvular disease (2) had a BiV PM (82) or BiV ICD (46) implanted in 2000-2007. AV delay was optimized individually, using echocardiography. Before and 3 months after implantation, the following was established: NYHA class, LVEF (echocardiographically), maximum oxygen uptake (spiroergometrically), left ventricle diastolic diameter and mitral regurgitation. The average follow-up time was 25.8+/-20.8 months. Complications and 2-year survival (n=68) were also assessed.
Results: 1) After 3 months of BiV pacing, NYHA class improved from 2.9+/-0.4 to 2.4+/-0.6 (n=99, p<0.001), LVEF increased from 20.2+/-4.9 to 23.9+/-6.6 % (n=92, p<0.001). Left ventricle diastolic diameter decreased from 69.8+/-8 to 67.5+/-10.0 mm (n=88, p=0.001) and mitral regurgitation was reduced from 2.2+/-0.9 to 1.9+/-0.9 (n=87, p=0.001) and maximum oxygen uptake during spiroergometry increased from 14.5+/-2.7 to 15.5+/-2.6 ml/min/kg (n=52, p=0.005). 2) Coronary sinus lead reposition was done in 2.3 %, epicardial lead implantation in 4.7 %, atrial lead reposition in 2.3 %, and right ventricular lead reposition in 2.3 % of patients. Contralateral reimplantation due to inflammatory complications in 1.6 % of patients. 3) Heart transplantation was performed on 9 patients. 4) Two-year survival was recorded in 77.9 % of 68 followed patients (72.2 % in CAD, 79.6 % in DCM).
Conclusion: In the retrospective study of patients with BiV pacing a decline in heart failure, an increase in cardiac pump efficiency, reverse remodelling of left ventricle and acceptable occurrence of complications were confirmed (Tab. 4, Fig. 7, Ref. 18). Full Text (Free, PDF) www.bmj.sk
Download full-text PDF |
Source |
|---|
Publication Analysis
Top Keywords
Similar Publications
First and Second Degree Left Bundle Branch Block and Masquerading Bundle Branch Block: Lessons Learned During Conduction System Pacing.
Heart Rhythm
January 2025
Geisinger Heart Institute, Geisinger Wyoming Valley Medical Center, MC 36-10, 1000 E Mountain Blvd, Wilkes-Barre, PA 18711.
Leadless Pacing: Current Status and Ongoing Developments.
Micromachines (Basel)
January 2025
Section of Electrophysiology, Division of Cardiology, Department of Internal Medicine, Rush University Medical Center, 1653 W. Congress, Chicago, IL 60612, USA.
Although significant strides have been made in cardiac pacing, the field is still evolving. While transvenous permanent pacing is highly effective in the management of bradyarrhythmias, it is not risk free and may result in significant morbidity and, rarely, mortality. Transvenous leads are often the weakest link in a pacing system.
View Article and Find Full Text PDFPermanent Left Bundle Branch Area DF-4 Defibrillator Lead Implantation-Feasibility, Procedural Caveats, Safety, and Follow-Up.
J Cardiovasc Electrophysiol
January 2025
Department of Cardiac Electrophysiology and Pacing, Arrhythmia Heart Failure Academy, The Madras Medical Mission, Chennai, Tamil Nadu, India.
Introduction: Permanent implantation of a DF-4 implantable cardiac defibrillator (ICD) lead in the left bundle branch area (LBBA-ICD) is the next paradigm in amalgamating cardiac resynchronization therapy (CRT) and defibrillation. We systematically investigated feasibility/success rate, procedural caveats, and complications associated with a permanent DF-4 LBBA ICD implant and pertinent data at short-term follow-up.
Methods: We prospectively attempted implantation of 7 Fr Durata (Abbott, Chicago, IL, USA) single coil DF-4 ICD lead at the LBBA using a fixed-curve non-deflectable CPS locator delivery sheath.
Gated myocardial perfusion SPECT for evaluating left ventricular dyssynchrony in cardiac resynchronization therapy candidates: a systematic review.
Nucl Med Commun
January 2025
Department of Cardiac and Vascular Diseases, St.John Paul II Hospital, Jagiellonian University Medical College, Krakow, Poland.
Objectives: Cardiac resynchronization therapy (CRT) is an intervention for heart failure patients with reduced ejection fraction who exhibit specific electrocardiographic indicators of electrical dyssynchrony. However, electrical dyssynchrony does not universally correspond to left ventricular mechanical dyssynchrony (LVMD). Gated single-photon emission computed tomography (SPECT) myocardial perfusion allows for the assessment of LVMD, yet its role in the CRT selection process remains debated.
View Article and Find Full Text PDFApplication prospect of speckle tracking echocardiography in pacemaker implantation.
Front Cardiovasc Med
January 2025
Department of Cardiology, The First People's Hospital of Neijiang, Neijiang, China.
More than 1 million permanent pacemakers are implanted worldwide each year, half of which are in patients with high-grade atrioventricular block. Pacemakers provide adequate frequency support in the initial stage, but traditional right ventricular (RV) pacing may lead to or aggravate left ventricular dysfunction and arrhythmia. Several potential risk factors for heart failure and arrhythmias after pacemaker surgery have been identified, but their occurrence remains difficult to predict clinically.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!