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Eligibility for biventricular pacing in patients with an implantable cardioverter defibrillator

S G Molhoek1, J J Bax, L van Erven

  • 1Dept of Cardiology, Leiden University Medical Center, Albinusdreef 2, 2333 ZA Leiden, The Netherlands.

European Journal of Heart Failure
|June 12, 2003
PubMed

Insights

Many patients receiving an implantable cardioverter defibrillator (ICD) also qualify for biventricular (BV) pacing. Combining ICD and BV pacing improves survival and reduces hospitalizations in heart failure patients.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Implantable cardioverter defibrillator (ICD) therapy reduces sudden cardiac death but not heart failure mortality.
  • Biventricular (BV) pacing shows promise for improving outcomes in heart failure patients.

Purpose of the Study:

  • To determine the proportion of patients indicated for ICD implantation who are also eligible for BV pacing.
  • To evaluate the combined benefits of ICD and BV pacing compared to ICD alone.

Main Methods:

  • Retrospective analysis of 390 patients who received an ICD between June 1996 and March 2001.
  • Eligibility for BV pacing assessed using NYHA class III-IV, QRS duration >120 ms, and depressed left ventricular ejection fraction (LVEF).

Main Results:

  • Of 390 patients, 79 (20%) met criteria for BV pacing eligibility.
  • Patients receiving both ICD and BV pacing demonstrated superior survival rates.
  • Combined therapy led to improved NYHA class and significantly lower hospitalization rates compared to ICD alone.

Conclusions:

  • A significant percentage of patients receiving ICDs are also candidates for BV pacing.
  • Concurrent ICD and BV pacing offers substantial benefits for heart failure patients.
  • Screening for BV pacing eligibility should be considered for patients undergoing ICD implantation.

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