Document Detail

Cardiac resynchronization therapy: predictive factors of unsuccessful left ventricular lead implant.
MedLine Citation:
PMID:  17255217     Owner:  NLM     Status:  MEDLINE    
AIMS: Cardiac resynchronization therapy is an established therapy for advanced heart failure. However, coronary sinus access and pacing is not achieved in about 5-10% of patients. The aim of this study was to identify predictive factors for failure of left ventricular (LV) lead transvenous implant. METHODS AND RESULTS: We evaluated 212 consecutive patients who received a cardiac resynchronization system. In 26 patients (12.3%), the attempt to pace the LV was unsuccessful. At univariate analysis, in patients with an unsuccessful implant a higher proportion of permanent atrial fibrillation (AF), valvular heart disease, and previous heart surgery were observed. Anteroposterior, longitudinal, and transversal left atrium diameters (LAD) were also larger among patients with an unsuccessful implant. The anteroposterior LAD (APLAD) with an optimal value to predict implant failure was 48.5 mm. At logistic regression analysis, the presence of permanent AF and APLAD were independent predictors of failed implant (OR 7.7, 95% CI 2.5-23.9, P=0.002 and OR 11.7, 95% CI 3.1-37.6, P<0.001, respectively). CONCLUSION: The presence of permanent AF and APLAD are factors that predict unsuccessful pacing from the LV.
Alfonso Macías; Ignacio García-Bolao; Ernesto Díaz-Infante; Jose María Tolosana; Bárbara Vidal; Juan José Gavira; Antonio Berruezo; Josep Brugada; Lluis Mont
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2007-01-25
Journal Detail:
Title:  European heart journal     Volume:  28     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-02-16     Completed Date:  2007-11-08     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  450-6     Citation Subset:  IM    
Thorax Institute, Hospital Clinic Universitari de Barcelona, Institut d'Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
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MeSH Terms
Atrial Fibrillation / therapy*,  ultrasonography
Cardiac Pacing, Artificial / methods*
Defibrillators, Implantable / standards*
Exercise Test
Pacemaker, Artificial*
Sensitivity and Specificity
Treatment Failure

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