Short-term effect of cardiac resynchronization therapy in patients with ischaemic or nonischaemic cardiomyopathy

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HUA Wei()
NIU Hong-xia()
WANG Fang-zheng()
CHEN Ke-ping()
CHEN Xin()
Journal Title:
Volume 119, Issue 18, 2006
Key Word:
cardiac resynchronization therapy;cardiomyopathy, ischaemic;nonischaemic

Abstract: Background Patients with heart failure were candidates for cardiac resynchronization therapy (CRT)regardless of underlying aetiology. This study observed the effect of CRT in patients with ischaemic or nonischaemic cardiomyopathy.Methods One hundred and forty-two patients with refractory chronic heart failure and left bundle branch block received cardiac resynchronization therapy, 91 men and 51 women, average age 60 years. Left ventricular ejection fraction (LVEF) was severely depressed (mean 29%), left ventricular end diastolic diameter (LVEDD)enlarged (mean 72 mm) and QRS width was lengthened (mean 147 ms). Ninety-eight had nonischaemic cardiomyopathy and 44 had ischaemic cardiomyopathy.Results After cardiac resynchronization therapy, the heart function was significantly improved. The mean LVEF increased from 29% to 36% after pacing. In patients with nonischaemic cardiomyopathy, the LVEF was improved from 28% to 37%, and in patients with ischaemic cardiomyopathy, the LVEF was improved from 30% to 36%. No significant difference of the improvement was found between the two groups (P>0.05).Conclusions Cardiac resynchronization therapy could significantly improve cardiac function in patients with chronic heart failure regardless of the underlying heart disease.

  • [1]Gregoratos G,Abrams J,Epstein AE,Freedman RA,Hayes DL,Hlatky MA,et al.ACC/AHNNASPE 2002 guideline update for implantation of cardiac pacemakers and antiarrhythmia devices:summary article:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines(ACC/AHA/NASPE Committee to Update the 1998 Pacemaker Guidelines).Circulation 2002;106:2145-2161.
  • [2]Hua W,Zhang S,Wang FZ,Zhang KJ,Niu GD,Chen KP.The application of over the wire technique to implant left ventricular lead.Chin J Arrhy (Chin) 2003;7:378-379.
  • [3]Mortensen PT,Sogaard P,Jensen HK,Kim WY,Hansen PS,Egeblad E,et al.A left ventricular pacing site at three o'clock or later in the left anterior oblique view:an easy way to predict responders to cardiac resynchronization with biventricular pacing.Pacing Clin electrophysiol 2001;24:552.
  • [4]Butter C,Auricchio A,Stellbrink C,Fleck E,Ding J,Yu Y,et al.Effect of resynchronization therapy stimulation site on the systolic function of heart failure patients.Circulation 2001 ;104:3026-3029.
  • [5]Gras D,Mabo P,Tang T,Luttikuis O,Chatoor R,Pedersen AK,et al.Multisite pacing as a supplemental treatment of congestive heart failure:preliminary results of the Medtronic Inc.InSync Study.Pacing Clin electrophysiol 1998;21:2249-2255.
  • [6]Hua W,Wang FZ,Zhang S,Zhang KJ,Niu GD,Ma J,et al.Clinical observation of resynchronization therapy for patients with chronic heart failure.Chin J Cardiol (Chin)2003;31:21-23.
  • [7]Bristow MR,Saxon LA,Boehmer J,Krueger S,Kass DA,De Marco T,et al.Cardiac-resynchronization therapy with or without an implantable defibrillator in advanced chronic heart failure.N Engl J Med 2004;350:2140-2150.
  • [8]Abraham WT,Fisher WG,Smith AL,Delurgio DB,Leon AR,Loh E,et al.Cardiac resynchronization in chronic heart failure.N Engl J Med 2002;346:1845-1853.
  • [9]Cazeau S,Leclercq C,Lavergne T,Walker S,Varma C,Linde C,et al.Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay.N Engl J Med 2002;344:873-880.
  • [10]Lunati M,Paolucci M,Oliva F,Frigerio M,Magenta G,Cattafi G,et al.Patient selection for biventricular pacing.J Cardiovasc Electrophysiol 2002;13 (1 Suppl):S63-67.
  • [11]Molhoek SG,Bax JJ,van Erven L,Bootsma M,Boersma E,Steendijk P,et al.Comparison of benefits from cardiac resynchronization therapy in patients with ischaemic cardiomyopathy versus idiopathic dilated cardiomyopathy.Am J Cardiol 2004;93:860-863.
  • [12]St John Sutton MG,Plappert T,Abraham WT,Smith AL,DeLurgio DB,Leon AR,et al.Effect of cardiac resynchronization therapy on left ventricular size and function in chronic heart failure.Circulation 2003;107:1985-1990.
  • [13]Reuter S,Garrigue S,Barold SS,Jais P,Hocini M,Haissaguerre M,et al.Comparison of characteristics in responders versus nonresponders with biventricular pacing for drug-resistant congestive heart failure.Am J Cardiol 2002;89:346-350.
  • [14]Teerlink JR,Massie BM,EPHESUS and COMPANION.Late breaking heart failure trials from the 2003 ACC meeting:EPHESUS and COMPANION.J Card Fail 2003;9:158-163.
  • [15]Salukhe TV,Francis DP,Sutton R.Comparison of medical therapy,pacing and defibrillation in heart failure (COMPANION) trial terminated early:combined biventricular pacemaker defibrillators reduce all-cause mortality and hospitalization.Int J Cardiol 2003;87:119-120.
  • [16]Albertsen AE,Nielsen JC,Pedersen AK,Hansen PS,Jensen HK,Mortensen PT.Left ventricular lead performance in cardiac resynchronization therapy:impact of lead localization and complications.Pacing Clin Electrophysiol 2005;28:483-488.
  • [17]Alonso C,Leclercq C,d'AIIonnes FR,Pavin D,Victor F,Mabo P,et al.Six year experience of transvenous left ventricular lead implantation for permanent biventricular pacing in patients with advanced heart failure:technical aspects.Heart 2001 ;86:405-410.
  • [18]Bradley DJ,Bradley EA,Baughman KL,Berger RD,Calkins H,Goodman SN,et al.Cardiac resynchronization and death from progressive heart failure,a meta-anaiysis of randomized controlled trials.JAMA 2003;289:730-740.
  • [19]Cleland JG,Daubert JC,Erdmann E,Freemantle N,Gras D,Kappenberger L,et al.The effect of cardiac resynchronization on morbidity and mortality in heart failure.N Engl J Med 2005;352:1539-1549.
  • [20]Swedberg K,Cleland J,Dargie H,Drexler H,Follath F,Komajda M,et al.Guidelines for the diagnosis and treatment of chronic heart failure:executive summary (update 2005):The Task Force for the Diagnosis and Treatment of Chronic Heart Failure of the European Society of Cardiology.Eur Heart J 2005;26:1115-1140.
  • [21]Hunt SA,American College of Cardiology,American Heart Association Task Force on Practice Guideline.ACC/AHA 2005 guideline update for the diagnosis and management of chronic heart failure in the adult:a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Update the 2001 Guidelines for the Evaluation and Management of Heart Failure).J Am Coil Cardiol 2005;46:e1-82.
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