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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

Relation of left ventricular lead placement in cardiac resynchronization therapy to left ventricular reverse

Aleksandr Rovner1, Lisa de las Fuentes, Mitchell N Faddis

  • 1Cardiovascular Imaging and Clinical Research Core Laboratory, St. Louis, Missouri, USA.

The American Journal of Cardiology
|January 16, 2007
PubMed

Insights

Optimal cardiac resynchronization therapy (CRT) involves lateral left ventricular (LV) lead placement. This position improves LV remodeling and diastolic dyssynchrony more effectively than other locations.

Area of Science:

  • Cardiology
  • Medical Imaging
  • Cardiac Electrophysiology

Background:

  • Left ventricular (LV) lead placement in cardiac resynchronization therapy (CRT) impacts cardiac remodeling and dyssynchrony.
  • Optimal LV lead positioning for CRT is not well-defined.

Purpose of the Study:

  • To evaluate the effects of different LV lead placements on LV remodeling and dyssynchrony after CRT.
  • To compare the echocardiographic outcomes based on LV lead location (lateral, posterolateral, anterolateral).

Main Methods:

  • Echocardiography and Tissue Doppler imaging were used to assess LV volumes, ejection fraction, and systolic/diastolic dyssynchrony.
  • Sixty-one patients undergoing CRT were analyzed before and after the procedure.
  • Analysis of variance determined the impact of lead placement on echocardiographic variables.

Main Results:

  • Lateral LV lead placement was associated with significantly smaller LV volumes compared to posterolateral placement (p <0.01).
  • Improved diastolic dyssynchrony was observed with lateral lead placement versus anterior placement (p <0.05).
  • No significant differences in LV ejection fraction or systolic dyssynchrony improvement were found among groups.

Conclusions:

  • Lateral LV lead placement in CRT patients promotes greater reverse LV remodeling.
  • Lateral lead placement significantly improves diastolic dyssynchrony compared to other locations.

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