Skip Navigation

European Journal of Heart Failure 2008 10(4):421-427; doi:10.1016/j.ejheart.2008.02.019
This Article
Right arrow Full Text Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in ISI Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Search for citing articles in:
ISI Web of Science (2)
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Macías, A.
Right arrow Articles by García-Bolao, I.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Macías, A.
Right arrow Articles by García-Bolao, I.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?

© 2008 European Society of Cardiology

Left ventricular pacing site in cardiac resynchronization therapy: Clinical follow-up and predictors of failed lateral implant

Alfonso Macías, Juan-José Gavira, Sara Castaño, Eduardo Alegría and Ignacio García-Bolao*

Department of Cardiology and Cardiovascular Surgery, University Clinic, School of Medicine, University of Navarra Pamplona, Spain

* Corresponding author. Department of Cardiology and Cardiovascular Surgery, University Clinic, C/ Pío XII, s/n. 31008 Pamplona, Spain. Tel.: +34 948 2554000; fax: +34 948 296500. E-mail address: igarciab{at}unav.es (I. García-Bolao).


  Abstract

The effects of the left ventricular (LV) pacing site on the clinical results of resynchronization therapy (CRT) are not well characterized. The aim of this study was to define the effect of LV lead location on clinical response and LV remodelling, and to identify predictors of failure to implant the LV lead in a lateral location.

One hundred and seventy two consecutive patients were evaluated at baseline and 6 months after CRT. In 128 patients, the LV lead was implanted in the lateral region (Group 1), while 44 received an anterior implant due to anatomical or electrical factors (Group 2). Group 1 was associated with a significantly better functional outcome assessed both by NYHA class (p < 0.001) and by the six-minute-walk test (p = 0.01) compared with group 2. LV ejection fraction and volumes, and inter- and intraventricular dyssynchrony only improved significantly (p < 0.01) in group 1. The only independent predictor of a failed lateral implant was the presence of ischaemic cardiomyopathy (OR 3.29, 95% CI 2.2–13.7; p = 0.02).

In conclusion, a lateral lead location results in a better functional outcome and greater reverse LV remodelling compared with anterior locations. The presence of ischaemic cardiomyopathy is a risk factor for a failed lateral LV implant.

Key Words: Cardiac resynchronization therapy • Heart failure • Coronary sinus • Left ventricular pacing site

Received August 13, 2007; Revised December 22, 2007; Accepted February 28, 2008


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Circ Arrhythm ElectrophysiolHome page
M. Biffi, C. Moschini, M. Bertini, D. Saporito, M. Ziacchi, I. Diemberger, C. Valzania, G. Domenichini, E. Cervi, C. Martignani, et al.
Phrenic Stimulation: A Challenge for Cardiac Resynchronization Therapy
Circ Arrhythm Electrophysiol, August 1, 2009; 2(4): 402 - 410.
[Abstract] [Full Text] [PDF]

Home page
 J Am Coll CardiolHome page
N. M. Hawkins, M. C. Petrie, M. I. Burgess, and J. J.V. McMurray
Selecting patients for cardiac resynchronization therapy: the fallacy of echocardiographic dyssynchrony.
J. Am. Coll. Cardiol., May 26, 2009; 53(21): 1944 - 1959.
[Abstract] [Full Text] [PDF]


Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.