Absence of additional improvement in outcome of patients receiving cardiac resynchronization therapy paced at the most delayed left ventricular region

作者：Deplagne Antoine; Lafitte Stephane; Reuter Sylvain; Reant Patricia; Ploux Sylvain; Mokrani Bile; Roudaut Raymond; Jais Pierre; Haissaguerre Michel; Clementy Jacques; DosSantos Pierre; Bordachar Pierre^*

来源：Archives of Cardiovascular Diseases, 2009, 102(8-9): 641-649.

DOI：10.1016/j.acvd.2009.05.005

• Cardiac resynchronization therapy
• Left ventricular pacing site
• Echocardiography

Background. - The choice of the optimal left ventricular (LV) pacing site remains an issue in patients requiring cardiac resynchronization therapy (CRT).
Aim. - This prospective study compared the outcome of patients paced at the most delayed LV region with that of patients paced at any other W site.
Methods. - Forty-four patients with severe heart failure underwent three-dimensional (3D) echocardiography before implantation and 3 days after implantation of a CRT device, to determine the most delayed LV region during spontaneous rhythm and during right ventricular pacing. The patients were divided subsequently into four groups: group 1 (n = 19), LV lead placed at the most delayed echocardiographic site in spontaneous rhythm; group 2 (n = 25), LV lead placed at any other site; group 3 (n = 21), LV lead placed at the most delayed echocardiographic site during right ventricular pacing; group 4 (n = 23), LV lead placed at any other site.
Results. - No significant differences were observed between the four groups before implantation. After 6 months of CRT, no significant differences were observed between groups 1 and 2 or between groups 3 and 4 in terms of change in New York Heart Association functional class, Minnesota living with heart failure questionnaire, 6-minute walk test, peak exercise oxygen consumption, 3D ventricular dyssynchrony and 3D LV ejection fraction.
Conclusion. - Implantation of the W lead in the most delayed region of the left ventricle determined by 3D echocardiography did not result in additional improvement in symptoms or W function.

• 出版日期2009-9
• 单位河南工业大学