PMID- 11869843
OWN - NLM
STAT- MEDLINE
DCOM- 20020320
LR  - 20190708
IS  - 0735-1097 (Print)
IS  - 0735-1097 (Linking)
VI  - 39
IP  - 5
DP  - 2002 Mar 6
TI  - Initial experience with an implantable cardioverter-defibrillator incorporating 
      cardiac resynchronization therapy.
PG  - 790-7
AB  - OBJECTIVES: The purpose of this study was to evaluate an implantable 
      cardioverter-defibrillator (ICD) incorporating biventricular pacing. BACKGROUND: 
      Biventricular pacing improves the symptoms of heart failure, a frequent problem 
      in ICD recipients. METHODS: This prospective multicenter study evaluated the 
      safety and efficacy of an ICD with biventricular pacing. RESULTS: A total of 84 
      patients with a standard ICD indication, symptomatic heart failure, left 
      ventricular (LV) ejection fraction <35% and a QRS duration >130 ms were included 
      in the trial. In 81 of 84 patients the LV lead was successfully implanted. 
      Patients significantly improved in the 6-min hall-walk test (baseline 304 plus 
      minus 131 m, three months 397 plus minus 142 m, p < 0.001), quality of life 
      (baseline 38.9 plus minus 21.2, three months 26.5 plus minus 21.2, p < 0.001) and 
      the New York Heart Association (NYHA) classification (baseline 2.8 plus minus 
      0.6, three months 2.2 plus minus 0.5). Left ventricular end-diastolic (from 79.6 
      plus minus 13.0 mm to 73.6 plus minus 12.9 mm, p = 0.002) and end-systolic (from 
      68.3 plus minus 13.5 mm to 63.9 plus minus 12.9 mm, p < 0.001) diameter 
      decreased, and fractional shortening increased (from 16 plus minus 6% to 18 plus 
      minus 6%, p = 0.018). Of the patients 26 experienced 472 episodes of spontaneous 
      sustained ventricular tachyarrhythmias. All episodes were successfully terminated 
      except for 16 episodes occurring in a patient with incessant ventricular 
      tachycardia. Biventricular antitachycardia pacing was more effective than right 
      ventricular antitachycardia pacing (p < 0.001). During follow-up (median 185 
      days, range 12 to 344 days) five patients died from progressive heart failure. 
      CONCLUSIONS: Incorporating biventricular pacing in an ICD is feasible and leads 
      to an improvement of heart failure symptoms. Therefore, this therapy may become 
      an option for patients who need ICD therapy in the presence of severe heart 
      failure.
FAU - Kuhlkamp, Volker
AU  - Kuhlkamp V
AD  - Medizinische Klinik III, Tubingen, Germany. volker.kuehlkamp@med.uni-tuebingen.de
CN  - InSync 7272 ICD World Wide Investigators
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Am Coll Cardiol
JT  - Journal of the American College of Cardiology
JID - 8301365
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Pacing, Artificial/*adverse effects
MH  - Defibrillators, Implantable/*adverse effects
MH  - Electrocardiography
MH  - Exercise Test
MH  - Feasibility Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*complications/*mortality
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prospective Studies
MH  - Stroke Volume/physiology
MH  - Survival Rate
MH  - Tachycardia, Ventricular/*mortality/physiopathology/*therapy
MH  - Time Factors
EDAT- 2002/03/01 10:00
MHDA- 2002/03/21 10:01
CRDT- 2002/03/01 10:00
PHST- 2002/03/01 10:00 [pubmed]
PHST- 2002/03/21 10:01 [medline]
PHST- 2002/03/01 10:00 [entrez]
AID - S0735109701018198 [pii]
AID - 10.1016/s0735-1097(01)01819-8 [doi]
PST - ppublish
SO  - J Am Coll Cardiol. 2002 Mar 6;39(5):790-7. doi: 10.1016/s0735-1097(01)01819-8.