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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

Left ventricular lead position and nonspecific conduction delay are predictors of mortality in patients during

Dirk Prochnau1, Helmut Kuehnert, Matthias Heinke

  • 1Department of Internal Medicine I, Friedrich Schiller University, Jena, Germany. dirk.prochnau@med.uni-jena.de

The Canadian Journal of Cardiology
|April 22, 2011
PubMed

Insights

Left ventricular lead position and nonspecific conduction delay predict mortality in cardiac resynchronization therapy (CRT) patients. Anterior or anterolateral LV lead placement is associated with increased risk.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Heart Failure Management

Background:

  • Cardiac resynchronization therapy (CRT) treats severe systolic heart failure with intraventricular conduction delay.
  • The impact of left ventricular (LV) pacing site and bundle-branch block type on mortality in CRT is not well understood.

Purpose of the Study:

  • To investigate the clinical significance of LV lead position and nonspecific conduction delay in CRT patients.
  • To identify predictors of mortality in patients undergoing CRT.

Main Methods:

  • 143 patients undergoing CRT implantation were analyzed.
  • LV lead position and bundle-branch block type were recorded at implantation.
  • Follow-up was conducted for a median of 19 months.

Main Results:

  • Mortality was significantly higher with anterior or anterolateral LV lead positions (P = 0.03).
  • Anterior/anterolateral LV lead position, nonspecific conduction delay, male sex, and NYHA class > III independently predicted mortality.
  • 39 patients (27.3%) died, primarily from cardiovascular causes.

Conclusions:

  • LV lead position is a significant predictor of mortality in CRT patients.
  • Nonspecific conduction delay also predicts mortality in this population.
  • Optimizing LV lead placement may improve CRT outcomes.
Abstract

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