Document Detail


Relation of left ventricular lead placement in cardiac resynchronization therapy to left ventricular reverse remodeling and to diastolic dyssynchrony.
MedLine Citation:
PMID:  17223425     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of left ventricular (LV) lead placement for cardiac resynchronization therapy (CRT) on LV remodeling and dyssynchrony are not well defined. Sixty-one patients (age 60 +/- 11 years, 76% men) were evaluated by echocardiography before and 4 +/- 2 months after CRT and grouped by the LV lead placement (lateral, posterolateral, or anterolateral). Echocardiographic measurements included LV volumes and LV ejection fraction. Tissue Doppler imaging was used to assess for inter- and intraventricular systolic and diastolic dyssynchrony. Analysis of variance was used to determine the effect of the LV lead placement on echocardiographic variables after CRT. The LV lead was placed in a lateral cardiac vein in 33 patients (54%), posterolateral in 15 (25%), and anterior in 13 (21%). Lateral LV lead placement was associated with significantly smaller LV volumes compared with the posterolateral lead placement (p <0.01). Diastolic dyssynchrony improved significantly with lateral lead placement compared with the anterior lead location (p <0.05). Improvement in LV ejection fraction and inter- and intraventricular systolic dyssynchrony was similar among the 3 groups. In conclusion, in patients undergoing CRT, a lateral lead location resulted in greater reverse LV remodeling and improved diastolic dyssynchrony compared with other lead placement locations.
Authors:
Aleksandr Rovner; Lisa de Las Fuentes; Mitchell N Faddis; Marye J Gleva; Victor G Dávila-Román; Alan D Waggoner
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't     Date:  2006-11-21
Journal Detail:
Title:  The American journal of cardiology     Volume:  99     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-15     Completed Date:  2007-02-27     Revised Date:  2011-09-28    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  239-41     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Imaging and Clinical Research Core Laboratory, St. Louis, Missouri, USA.
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MeSH Terms
Descriptor/Qualifier:
Diastole
Echocardiography, Doppler
Electric Countershock / instrumentation*
Electrodes, Implanted*
Female
Follow-Up Studies
Heart Ventricles / physiopathology,  ultrasonography
Humans
Male
Middle Aged
Myocardial Contraction / physiology*
Single-Blind Method
Stroke Volume / physiology
Tachycardia, Ventricular / complications,  physiopathology,  therapy*
Treatment Outcome
Ventricular Dysfunction, Left / complications,  physiopathology*,  therapy
Ventricular Remodeling / physiology*
Grant Support
ID/Acronym/Agency:
K24HL67002/HL/NHLBI NIH HHS; L30 HL074749-03/HL/NHLBI NIH HHS; T32-HL007081-29/HL/NHLBI NIH HHS

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