|Coronary artery bypass grafting with and without concomitant epicardial cardiac resynchronization therapy in patients with ischemic cardiomyopathy: a randomized study.|
|PMID: 20534420 Owner: NLM Status: MEDLINE|
|BACKGROUND: Epicardial implantation of a cardiac resynchronization therapy (CRT) system during coronary artery bypass grafting (CABG) may be an additional treatment method for improving left ventricle (LV) systolic function and dyssynchrony in patients with ischemic heart failure.
OBJECTIVE: The objective was to compare the long-term results in patients with severe ischemic heart failure who underwent CABG alone or CABG combined with concomitant epicardial implantation of a CRT system.
METHODS: One hundred sixty-four consecutive patients with severe ischemic heart failure and LV dyssynchrony were enrolled into 2 groups: CABG alone (n = 80) and epicardial CRT implantation during CABG (CABG + CRT) (n = 84). This prospective, randomized, and single-blind study was designed to compare clinical and echocardiography data after 6, 12, and 18 months of follow-up.
RESULTS: In the CABG group, LV systolic function, dyssynchrony signs, and quality of life did not change postoperatively, compared with preoperative data. In contrast, these parameters significantly improved in the CABG + CRT group. The 2 treatment groups did not differ with respect to postoperative improvement in Canadian Cardiovascular Society class (P = .68). The improvement in the New York Heart Association functional class was much more pronounced in the CABG + CRT group than in the CABG group (P = .029). In the CABG group, 21 patients (26.2%) had died by the 18-month follow-up, compared with 9 patients (10.7%) in the CABG + CRT group (P = .012, log-rank test).
CONCLUSION: Epicardial implantation of a CRT system concomitantly with CABG facilitates the early postoperative period, improves LV systolic function, improves the quality of life, and decreases LV dyssynchrony. Moreover, mortality in the CABG + CRT group was significantly lower than in the CABG group.
|Evgueny Pokushalov; Alexander Romanov; Darya Prohorova; Alexander Cherniavsky; Alexander Karaskov; Borut Gersak|
|Type: Comparative Study; Journal Article; Randomized Controlled Trial|
|Title: The heart surgery forum Volume: 13 ISSN: 1522-6662 ISO Abbreviation: Heart Surg Forum Publication Date: 2010 Jun|
|Created Date: 2010-06-10 Completed Date: 2011-06-02 Revised Date: 2014-07-30|
Medline Journal Info:
|Nlm Unique ID: 100891112 Medline TA: Heart Surg Forum Country: United States|
|Languages: eng Pagination: E177-84 Citation Subset: IM|
|APA/MLA Format Download EndNote Download BibTex|
Cardiac Pacing, Artificial / methods*
Cardiomyopathies / mortality, surgery*, ultrasonography
Coronary Artery Bypass / methods*
Health Status Indicators
Myocardial Ischemia / mortality, surgery*, ultrasonography
Ventricular Function, Left
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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