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[Combined cardiac resynchronization and implantable cardioversion defibrillation].
Quan Fang1, Tao Guo, K Jackson
1Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing 100730, China.
Zhonghua Xin Xue Guan Bing Za Zhi
|June 1, 2005
Summary
Implantation of combined cardiac resynchronization therapy (CRT) and implantable cardioverter-defibrillator (ICD) devices is safe in elderly patients. Further studies are needed to observe the long-term clinical efficacy of these combined devices.
Area of Science:
- Cardiology
- Medical Devices
- Electrophysiology
Background:
- Patients with heart failure often require advanced therapies like cardiac resynchronization therapy (CRT) and implantable cardioverter-defibrillators (ICD) to manage arrhythmias and improve cardiac function.
- Combined CRT-ICD devices offer a potential solution for patients needing both therapies, simplifying management and potentially improving outcomes.
Purpose of the Study:
- To evaluate the safety and efficacy of implanting a novel device with combined CRT and ICD capabilities.
- To assess the procedural success and early outcomes of this combined device implantation in a patient cohort.
Main Methods:
- Eleven patients (48-80 years old) with heart failure (LVEF ≤35%, QRS duration ≥120ms) and high risk for sudden cardiac death received a combined CRT-ICD device.
- Left ventricular leads were placed in the coronary sinus branches under general anesthesia, with AV interval optimization post-procedure using echocardiography.
- Device parameters, including lead thresholds and defibrillation thresholds (DFT), were assessed post-implantation.
Main Results:
- All procedures were completed successfully without major complications.
- Lead parameters (amplitude, resistance, threshold) were within acceptable ranges for atrial, right ventricular, and left ventricular leads.
- Successful defibrillation thresholds were achieved in most patients, with two requiring external defibrillation or experiencing ECG abnormalities during DFT testing. Improvement in mitral regurgitation was observed post-AV optimization.
Conclusions:
- Implantation of combined CRT-ICD devices is a safe procedure, even in an aging patient population.
- The study demonstrates the feasibility of implanting these devices, with initial results suggesting safety and potential benefits.
- Long-term clinical efficacy and outcomes of this combined device require further investigation.