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Cardiac resynchronization therapy in advanced heart failure the multicenter InSync clinical study
Daniel Gras1, Christophe Leclercq, Anthony S L Tang
1Unité de Soins et de Cardiologie Interventionnelle, Polyclinique Saint Henri, Place Beaumanoir, 44100, Nantes, France. dangras@aol.com
European Journal of Heart Failure
|May 30, 2002
Summary
Atrio-biventricular pacing offers a safe and effective method for cardiac resynchronization therapy in advanced heart failure patients. This approach significantly improves heart function, symptoms, and quality of life over the long term.
Area of Science:
- Cardiology
- Medical Devices
Background:
- Recent observations suggest improved cardiac function with atrio-biventricular pacing.
- Heart failure symptoms can be alleviated through this pacing method.
Purpose of the Study:
- To assess the safety and feasibility of transvenous atrio-biventricular pacing.
- To examine long-term cardiac resynchronization effects in advanced heart failure.
Main Methods:
- 103 patients received a cardiac resynchronization system (CRS) with an atrio-biventricular lead.
- Evaluations included ECG, NYHA class, QOL, 6-MW, and echocardiography (in 46 patients).
- Measurements were repeated at 1, 3, 6, and 12 months post-implantation.
Main Results:
- A single, self-limiting complication occurred; 12-month survival was 78%.
- Significant improvements observed in NYHA class, 6-MW, QOL, and QRS duration.
- Left ventricular ejection fraction increased (21.7% to 26.1%), and LV filling time increased (363ms to 408ms).
Conclusions:
- Transvenous atrial synchronized biventricular pacing is safe and reliable for long-term use.
- Clinically relevant improvements in functional status, QOL, and LV performance were achieved.
- Further randomized controlled trials are anticipated to confirm these findings.