AI Article Synopsis
- A study investigated whether selecting the site for left ventricular (LV) pacing with a quadripolar lead improves outcomes for heart failure patients undergoing cardiac resynchronization therapy (CRT).
- After randomizing 43 patients into two groups (one using a quadripolar lead and the other a bipolar lead), results showed that those with the quadripolar lead had a significant increase in ejection fraction (EF) after 3 months compared to the bipolar group.
- Furthermore, 96% of patients in the quadripolar group experienced an improvement in their New York Heart Association (NYHA) class compared to 60% in the bipolar group, indicating better overall effectiveness of the quadripolar lead.
Article Abstract
Background: Not all heart failure (HF) patients benefit from cardiac resynchronization therapy (CRT). We assessed whether choosing the site of left ventricular (LV) pacing by a quadripolar lead may improve response to CRT.
Methods and results: We prospectively randomized 23 patients with HF (67±11 years; 21 males) to CRT with a quadripolar LV lead (group 1, with the LV pacing site chosen on the basis of QRS shortening using simultaneous biventricular pacing), and 20 patients (71±6 years; 16 males) to a bipolar LV lead (group 2, with devices programmed with a conventional tip-to-ring configuration). New York Heart Association (NYHA) class and LV ejection fraction (EF) by 2D echocardiography were assessed at baseline and after 3 months. The baseline EF was not different between the 2 groups (25±6% group 1 vs. 27±3% group 2; P=0.22), but after 3 months EF was higher in group 1 (35±13% group 1 vs. 31±4% group 2; P<0.001). A reduction in at least 1 NYHA class at 3 months was observed in 22 (96%) and 12 (60%) of group 1 and group 2 patients, respectively (P<0.05).
Conclusions: CRT with a quadripolar LV lead was associated with an improvement of EF greater than that observed in patients receiving a bipolar LV lead. In devices with a quadripolar lead, CRT programming based on the best QRS shortening is reliable and effective. (Circ J 2016; 80: 613-618).
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| http://dx.doi.org/10.1253/circj.CJ-15-0932 | DOI Listing |
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