PMID- 11843470
OWN - NLM
STAT- MEDLINE
DCOM- 20020724
LR  - 20190910
IS  - 1045-3873 (Print)
IS  - 1045-3873 (Linking)
VI  - 13
IP  - 1 Suppl
DP  - 2002 Jan
TI  - Patient selection for biventricular pacing.
PG  - S63-7
AB  - INTRODUCTION: Biventricular pacing improves functional status in the majority of 
      patients with drug-refractory heart failure, dilated cardiomyopathy, and 
      interventricular conduction delay. The aim of this study was to analyze the 
      baseline clinical and functional data of a cohort of patients implanted with a 
      biventricular stimulation system in a single-center experience, to verify if the 
      pathophysiologic characteristics of patients affect outcome, and to determine if 
      preliminary identification of the right candidates for the new therapy is 
      possible with noninvasive parameters. METHODS AND RESULTS: Since March 1999, 52 
      patients with advanced heart failure (idiopathic cardiomyopathy 50%, ischemic 
      cardiomyopathy 35%, other etiology 15%) and left bundle branch block underwent 
      cardiac resynchronization and were followed prospectively. Paired analysis over 
      mean (+/- SD) follow-up of 348 +/- 154 days showed an overall significant 
      decrease of QRS width (baseline 194 +/- 33.2 msec vs follow-up 159.6 +/- 20.1 
      msec), New York Heart Association (NYHA) functional class (baseline 3.2 +/- 0.5 
      vs follow-up 2.3 +/- 0.5), quality-of-life score (baseline 54 +/- 25 vs follow-up 
      25 +/- 16), and increase of maximal VO2 (baseline 12.6 +/- 2.5 mL/kg/min vs 
      follow-up 15.0 +/- 3.3 mL/kg/min). There were 80% responders (documented, 
      persistent decrease > or = 1 NYHA class) and 20% nonresponders (same NYHA class 
      or decline of status; need for heart transplant; death due to progressive pump 
      failure). No significant differences in baseline clinical and functional 
      variables between the two subgroups were observed. In responders, there was a 
      highly significant global improvement of all variables; in nonresponders, no 
      parameters changed between baseline and follow-up. CONCLUSION: These data confirm 
      the role of biventricular pacing in improving the functional status of the great 
      majority of a selected patient population having advanced heart failure and left 
      bundle branch block with wide QRS complex. Basal demographic, clinical, and 
      functional characteristics are not helpful in preliminary selection of 
      responders. Simple evaluation of NYHA class confirms favorable outcome 
      (improvement of functional and hemodynamic status).
FAU - Lunati, Maurizio
AU  - Lunati M
AD  - Department of Cardiology De Gasperis, Niguarda Hospital, Milan, Italy. 
      infodega@tin.it
FAU - Paolucci, Marco
AU  - Paolucci M
FAU - Oliva, Fabrizio
AU  - Oliva F
FAU - Frigerio, Maria
AU  - Frigerio M
FAU - Magenta, Giovanni
AU  - Magenta G
FAU - Cattafi, Giuseppe
AU  - Cattafi G
FAU - Vecchi, Rita
AU  - Vecchi R
FAU - Vicini, Ilaria
AU  - Vicini I
FAU - Cavaglia, Sergio
AU  - Cavaglia S
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PL  - United States
TA  - J Cardiovasc Electrophysiol
JT  - Journal of cardiovascular electrophysiology
JID - 9010756
SB  - IM
MH  - Bundle-Branch Block/complications
MH  - *Cardiac Pacing, Artificial
MH  - Cardiomyopathies/complications
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/etiology/*therapy
MH  - Heart Ventricles
MH  - Hemodynamics/physiology
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pacemaker, Artificial
MH  - *Patient Selection
MH  - Retrospective Studies
MH  - Survival Analysis
EDAT- 2002/02/15 10:00
MHDA- 2002/07/26 10:01
CRDT- 2002/02/15 10:00
PHST- 2002/02/15 10:00 [pubmed]
PHST- 2002/07/26 10:01 [medline]
PHST- 2002/02/15 10:00 [entrez]
AID - 10.1111/j.1540-8167.2002.tb01956.x [doi]
PST - ppublish
SO  - J Cardiovasc Electrophysiol. 2002 Jan;13(1 Suppl):S63-7. doi: 
      10.1111/j.1540-8167.2002.tb01956.x.