PMID- 10089857
OWN - NLM
STAT- MEDLINE
DCOM- 19990407
LR  - 20190622
IS  - 0002-9149 (Print)
IS  - 0002-9149 (Linking)
VI  - 83
IP  - 5B
DP  - 1999 Mar 11
TI  - Potential benefit of biventricular pacing in patients with congestive heart 
      failure and ventricular tachyarrhythmia.
PG  - 143D-150D
AB  - Treatment of congestive heart failure (CHF) aims for symptomatic relief and 
      reduction of mortality both from sudden death and pump failure. The implantable 
      cardioverter defibrillator (ICD) is highly effective in the prevention of sudden 
      death, but no mortality benefit in advanced CHF has yet been shown. Biventricular 
      pacing may lead to functional improvement in selected patients with CHF. Thus, a 
      biventricular pacemaker with defibrillation capabilities may be ideal for 
      patients with advanced CHF. We retrospectively analyzed the data from 384 
      patients (age 59 +/- 12 years, 322 male and 62 female) with regard to New York 
      Heart Association (NYHA) CHF class, mean QRS duration, mean PR interval, presence 
      of a QRS > 120 msec and incidence of atrial fibrillation at the time of ICD 
      implantation. Based on eligibility criteria from studies in biventricular pacing, 
      we analyzed how many patients may benefit from biventricular pacing. Patients 
      with CHF were older (NYHA class III: 60.9 +/- 9.7, class II: 61.3 +/- 10 versus 
      class I: 50.8 +/- 13.6 years, p < 0.001 each) and mean QRS duration was longer 
      with advanced CHF (NYHA class III 127.8 +/- 30 msec; class II 119.4 +/- 27.7 
      msec; class 0-1: 103.9 +/- 17.7 msec, p < 0.001, analysis of variance) as was the 
      mean PR interval (NYHA class III 189.9 +/- 33.5 msec; class II 176.1 +/- 29.3 
      msec; class 0-1 162.7 +/- 45.9 msec, p < 0.001, analysis of variance). The 
      incidence of atrial fibrillation was higher in class III (25.5%) compared with 
      class 0-1 (16.9%) and class II patients (14.1%, p = 0.043, chi-square test). A 
      total of 28 patients (7.3%) fulfilled eligibility criteria for biventricular 
      pacing if NYHA class III patients were considered candidates and 48 (12.5%) if 
      patients with NYHA II CHF and ejection fraction < or = 30% were included. Thus, 
      biventricular pacing may offer a promising therapeutic approach for a significant 
      proportion of patients with CHF at risk for ventricular tachyarrhythmia.
FAU - Stellbrink, C
AU  - Stellbrink C
AD  - Department of Cardiology and Internal Medicine, University of Technology, Aachen, 
      Germany.
FAU - Auricchio, A
AU  - Auricchio A
FAU - Diem, B
AU  - Diem B
FAU - Breithardt, O A
AU  - Breithardt OA
FAU - Kloss, M
AU  - Kloss M
FAU - Schondube, F A
AU  - Schondube FA
FAU - Klein, H
AU  - Klein H
FAU - Messmer, B J
AU  - Messmer BJ
FAU - Hanrath, P
AU  - Hanrath P
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Aged
MH  - Combined Modality Therapy
MH  - Death, Sudden, Cardiac/etiology/prevention & control
MH  - *Defibrillators, Implantable
MH  - Electrocardiography, Ambulatory
MH  - Equipment Design
MH  - Female
MH  - Heart Failure/mortality/physiopathology/*therapy
MH  - Heart Ventricles/physiopathology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Pacemaker, Artificial
MH  - Retrospective Studies
MH  - Stroke Volume/physiology
MH  - Survival Rate
MH  - Tachycardia, Ventricular/mortality/physiopathology/*therapy
EDAT- 1999/03/25 00:00
MHDA- 1999/03/25 00:01
CRDT- 1999/03/25 00:00
PHST- 1999/03/25 00:00 [pubmed]
PHST- 1999/03/25 00:01 [medline]
PHST- 1999/03/25 00:00 [entrez]
AID - S0002-9149(98)01016-9 [pii]
AID - 10.1016/s0002-9149(98)01016-9 [doi]
PST - ppublish
SO  - Am J Cardiol. 1999 Mar 11;83(5B):143D-150D. doi: 10.1016/s0002-9149(98)01016-9.