Document Detail


The BRIGHT study: bifocal right ventricular resynchronization therapy: a randomized study.
MedLine Citation:
PMID:  17684064     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: The BRIGHT study evaluated bifocal right ventricular (RV) (apex and outflow tract) pacing in a single, blind, randomized crossover study in patients eligible for cardiac resynchronization therapy (CRT). Forty-two patients were enrolled with the following characteristics: chronic drug refractory heart failure New York Heart Association (NYHA) class III-IV; ejection fraction (EF)<35%; QRS width >or= 120 ms; and a left bundle branch block. The aim of the study was to assess an improvement in left ventricular (LV) EF, 6 min walk test, Minnesota quality-of-life score, and NYHA classification. Methods and result Patients were randomized to receive either bifocal pacing or the control mode, each for a period of 3 months. Parameters were measured prior to randomization and after 3 months of control or bifocal pacing. Eight patients failed to make the 7 month follow-up, three patients died (one prior to randomization at the first month), five patients dropped out, and three patients refused further participation. One patient had a persistent lead problem, which was subsequently replaced with an LV lead, and one patient suffered with persistent atrial fibrillation. Compared with baseline, bifocal pacing improved EF from 26 +/- 12% to 36 +/- 11% (P < 0.0008), NYHA classification decreased from 2.8 +/- 0.4 to 2.3 +/- 0.7 (P < 0.007). Furthermore, the 6 min walk test improved from 372 +/- 129 m to 453 +/- 122 m (P < 0.05), and the Minnesota Living with Heart Failure scores decreased from 33 +/- 20 to 24 +/- 21 (P < 0.006). In the control group, no significant changes in any parameters were observed. Eight patients did not tolerate reprogramming from DDD BRIGHT to control pacing, with symptoms disappearing in all patients after reprogramming to bifocal pacing. CONCLUSION: Bifocal RV pacing in patients with a classic indication for CRT shows improvement in all parameters.
Authors:
Jan C J Res; Marcel J J A Bokern; Carel C de Cock; Ton van Loenhout; Patrick N A Bronzwaer; Han A M Spierenburg;
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2007-08-07
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  9     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2007 Oct 
Date Detail:
Created Date:  2007-10-01     Completed Date:  2008-04-25     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  857-61     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Ba 579, Erasmus Medical Centre Rotterdam, PO Box 2040, 3000 CA Rotterdam, The Netherlands. j.res@erasmusmc.nl
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrial Fibrillation / etiology,  therapy*
Cardiac Pacing, Artificial / methods*
Female
Heart Failure / therapy
Humans
Male
Middle Aged
Pilot Projects
Quality of Life
Questionnaires
Time Factors
Treatment Outcome
Ventricular Dysfunction, Right / etiology,  physiopathology,  therapy

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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