Document Detail

A prospective longitudinal evaluation of the benefits of epicardial lead placement for cardiac resynchronization therapy.
MedLine Citation:
PMID:  19797148     Owner:  NLM     Status:  MEDLINE    
AIMS: Cardiac resynchronization therapy (CRT) is a recognized treatment for appropriate patients. However, placement of the transvenous left ventricular lead is unsuccessful in 5-10% of patients and a further 20% fail to respond. For these groups, epicardial left ventricular lead placement is one alternative. We prospectively evaluated the effects of epicardial vs. transvenous placed CRT. METHODS AND RESULTS: Twenty-three subjects with unsuccessful transvenous coronary sinus lead placement underwent epicardial implantation. The subjects underwent clinical evaluation, cardiopulmonary exercise testing, and echocardiography before 3 and 6 months after. The results were compared with a control group (n = 35) who had received transvenous CRT. In both groups, there were significant improvements in all measures at 3 and 6 months. The improvement in peak VO(2) was delayed in the epicardial group compared with the transvenous group. At 6 months, the improvements seen in all variables showed no difference between the groups. CONCLUSION: Epicardial lead placement is a viable option for patients with unsuccessful coronary sinus lead placement. The improvements in most variables were of a similar magnitude and over a similar time scale compared with transvenous placement. Improvements in peak VO(2) were delayed in the epicardial group, probably as a result of a prolonged recovery time.
Ashish Patwala; Paul Woods; Richard Clements; Khaled Albouaini; Archana Rao; David Goldspink; Lip-Bun Tan; Aung Oo; David Wright
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Publication Detail:
Type:  Controlled Clinical Trial; Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  11     ISSN:  1532-2092     ISO Abbreviation:  Europace     Publication Date:  2009 Oct 
Date Detail:
Created Date:  2009-10-02     Completed Date:  2010-01-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  1323-9     Citation Subset:  IM    
Liverpool Heart and Chest Hospital, Liverpool L14 3PE, UK.
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MeSH Terms
Cardiac Pacing, Artificial / methods*
Electrodes, Implanted*
Heart Failure / diagnosis,  prevention & control*
Heart Ventricles / surgery*
Longitudinal Studies
Pacemaker, Artificial*
Pericardium / surgery*
Prospective Studies
Prosthesis Implantation / methods*
Treatment Outcome

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

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