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Totally epicardial cardiac resynchronization therapy system implantation in patients with heart failure undergoing

Kinga Goscinska-Bis1, Jaroslaw Bis, Michal Krejca

  • 1Department of Electrocardiology, Medical University of Silesia, Katowice, Poland.

European Journal of Heart Failure
|April 17, 2008
PubMed

Insights

Totally epicardial cardiac resynchronization therapy (CRT) implanted during coronary artery bypass grafting (CABG) significantly improved heart failure (HF) patients' clinical and echocardiographic outcomes.

Area of Science:

  • Cardiology
  • Cardiac Surgery
  • Biomedical Engineering

Background:

  • Systolic dyssynchrony affects numerous heart failure (HF) patients undergoing coronary artery bypass grafting (CABG).
  • Coronary artery bypass grafting (CABG) provides a suitable environment for implanting totally epicardial cardiac resynchronization therapy (CRT) systems.

Purpose of the Study:

  • To evaluate the effectiveness of totally epicardial CRT implantation during CABG in heart failure (HF) patients.

Main Methods:

  • A randomized, single-blind, cross-over study involving 23 HF patients with dyssynchrony undergoing totally epicardial CRT implantation during CABG.
  • Patients were compared across two 3-month periods: active CRT (CRT+) and inactive CRT (CRT-) pacing.

Main Results:

  • Twenty-two patients completed the study. The CRT+ group showed significant improvements in NYHA class (p=0.028), 6-minute walk test distance (p=0.047), and quality of life (p=0.003) compared to CRT-.
  • Echocardiography demonstrated improved LV ejection fraction (p<0.001), smaller LV end-systolic volume (p=0.04), reduced mitral regurgitation (p=0.026), and enhanced LV synchrony in the CRT+ group.

Conclusions:

  • Totally epicardial CRT systems implanted during CABG offer additional clinical and echocardiographic benefits for HF patients with systolic dyssynchrony.
Abstract

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