Document Detail


Comparison of stimulation sites within left ventricular veins on the acute hemodynamic effects of cardiac resynchronization therapy.
MedLine Citation:
PMID:  15851339     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to study the acute hemodynamic effect of left ventricular (LV) stimulation sites within a coronary vein. BACKGROUND: Access to LV stimulation sites for resynchronization therapy is achieved using specialized lead systems navigated through a coronary vein. The effects of stimulation in different coronary veins have been evaluated previously, but less is known about stimulation sites within a coronary vein. METHODS: Twenty-four patients (New York Heart Association functional class II-IV, age 59 +/- 10 years, ejection fraction 21 +/- 7%, QRS 166 +/- 30 ms) were enrolled in the study. A novel over-the-wire lead system was used to access an anterior or lateral coronary vein. At each lead location, a randomized stimulation protocol was executed. Hemodynamic responses were evaluated using LV dP/dtmax. RESULTS: The mean time to cannulate the coronary sinus and position the LV lead was 19 +/- 30 minutes and 17 +/- 18 minutes, respectively. Data from stimulation at two sites within a coronary vein were obtained in 19 patients (anterior vein 11; lateral vein 8). Of these patients, 14 (anterior vein 9; lateral vein 5) showed large improvement in dP/dtmax (22%-25% in anterior vein, 37%-40% in lateral vein). Overall, there were no group differences in hemodynamic effects among different stimulation sites within a coronary vein, although significant variability among sites was observed in individuals. CONCLUSIONS: Resynchronization therapy through a coronary vein improves acute hemodynamic function of heart failure patients with LV conduction disorder. There were no significant differences between basal and apical pacing sites for this group.
Authors:
Michael R Gold; Angelo Auricchio; John D Hummel; Michael C Giudici; Jiang Ding; Bruce Tockman; Julio Spinelli
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Heart rhythm : the official journal of the Heart Rhythm Society     Volume:  2     ISSN:  1547-5271     ISO Abbreviation:  Heart Rhythm     Publication Date:  2005 Apr 
Date Detail:
Created Date:  2005-04-26     Completed Date:  2005-06-13     Revised Date:  2009-10-27    
Medline Journal Info:
Nlm Unique ID:  101200317     Medline TA:  Heart Rhythm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  376-81     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. goldmr@musc.edu
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial / methods*
Coronary Vessels
Female
Heart Conduction System
Heart Failure / physiopathology,  therapy*
Heart Ventricles / physiopathology*
Hemodynamics
Humans
Male
Middle Aged
Prospective Studies
Ventricular Dysfunction, Left / physiopathology*

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


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