| Comparison of stimulation sites within left ventricular veins on the acute hemodynamic effects of cardiac resynchronization therapy. | |
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MedLine Citation:
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PMID: 15851339 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Michael R Gold; Angelo Auricchio; John D Hummel; Michael C Giudici; Jiang Ding; Bruce Tockman; Julio Spinelli |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't |
Journal Detail:
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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:
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Created Date: 2005-04-26 Completed Date: 2005-06-13 Revised Date: 2009-10-27 |
Medline Journal Info:
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Nlm Unique ID: 101200317 Medline TA: Heart Rhythm Country: United States |
Other Details:
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Languages: eng Pagination: 376-81 Citation Subset: IM |
Affiliation:
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Division of Cardiology, Medical University of South Carolina, Charleston, South Carolina 29425, USA. goldmr@musc.edu |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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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