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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
12:45

Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Comparative effects of ventricular resynchronization therapy in heart failure patients with or without coronary

C Leclercq1, D Gras, A Tang

  • 1Département de cardiologie et maladies vasculaires, Centre cardio-pneumologique, Hôpital Pontchaillou-CHU, rue Henri le Guilloux, 35033 Rennes cedex 9, France. christophe.leclercq@chu-rennes.fr

Annales De Cardiologie Et D'Angeiologie
|September 17, 2004
PubMed

Insights

Biventricular pacing significantly improves heart failure symptoms and functional status in patients with intraventricular conduction delay and left ventricular systolic dysfunction. This benefit is observed regardless of whether the heart failure is ischemic or non-ischemic in origin.

Area of Science:

  • Cardiology
  • Medical Devices
  • Heart Failure Management

Background:

  • Advanced heart failure often involves intraventricular conduction delay (IVCD) and left ventricular systolic dysfunction (LVSD).
  • Multisite cardiac pacing offers a potential additive treatment strategy for these patients.

Purpose of the Study:

  • To assess the clinical effectiveness of atrioventricular pacing in patients with LVSD and IVCD.
  • To compare outcomes based on the etiology of LVSD, specifically comparing ischemic and non-ischemic heart disease.

Main Methods:

  • The InSync trial included 103 patients receiving biventricular pacemakers.
  • Baseline and follow-up evaluations (ECG, NYHA Class, QOL, 6-minute walk test) were conducted up to 12 months post-implantation.
  • Patients were categorized into ischemic (N=48) and non-ischemic (N=55) groups based on coronary artery disease status.

Main Results:

  • Mortality rates were similar between groups (78% 12-month survival).
  • Significant improvements were observed in QRS duration, NYHA class, quality of life, and 6-minute walk test distance in both groups.
  • The delay between death and pacemaker implantation was longer in the non-ischemic group.

Conclusions:

  • Biventricular pacing effectively improves the functional status of patients with LVSD, IVCD, and advanced heart failure.
  • The benefits of biventricular pacing are consistent across both ischemic and non-ischemic etiologies of heart failure.
  • Biventricular pacing does not increase mortality in ischemic heart failure patients.
Abstract

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