© 2008 European Society of Cardiology
Totally epicardial cardiac resynchronization therapy system implantation in patients with heart failure undergoing CABG
a Department of Electrocardiology, Medical University of Silesia Katowice, Poland
b Ist Department of Cardiac Surgery, Medical University of Silesia Ziolowa 47, 40-635 Katowice, Poland
* Corresponding author. Tel.: +48 32 3598641; fax: +48 32 2527066. E-mail addresses: bisu{at}mp.pl (J. Bis).
 |
Abstract |
|---|
Background: Systolic dyssynchrony is present in a considerable number of patients with heart failure (HF) undergoing coronary artery bypass grafting (CABG). Surgical revascularization offers an optimal setting for totally epicardial cardiac resynchronization therapy (CRT) system implantation.
Aim: To assess the efficacy of totally epicardial CRT implantation during CABG, in patients with HF.
Methods: Twenty three patients with HF and dyssynchrony underwent totally epicardial CRT system implantation during CABG. This randomised, single-blind, cross-over study compared clinical and echocardiographic parameters during two periods: 3 months of active CRT (CRT+) and 3 months of inactive CRT (CRT–) pacing.
Results: Twenty two patients underwent randomisation and completed both study periods. In the CRT+ group more patients improved by two NYHA classes (p=0.028), had a longer 6-minute walk test distance (p=0.047) and better quality of life (p=0.003) compared with the CRT– group. Echocardiography revealed an improved LV ejection fraction (p<0.001), smaller LV end-systolic volume (p=0.04), reduced mitral regurgitation (p=0.026) and improved LV synchrony in the CRT+ group compared with the CRT– group.
Conclusion: CRT delivered by a totally epicardial system implanted during CABG is associated with additional improvement of clinical and echocardiographic parameters in patients with HF and systolic dyssynchrony.
Key Words: Pacing • Resynchronization • Heart failure • CABG
Received October 14, 2007; Revised January 22, 2008; Accepted March 12, 2008