PMID- 17302712
OWN - NLM
STAT- MEDLINE
DCOM- 20070612
LR  - 20080118
IS  - 0147-8389 (Print)
IS  - 0147-8389 (Linking)
VI  - 30 Suppl 1
DP  - 2007 Jan
TI  - Long-term follow-up of biventricular pacing using a totally endocardial approach 
      in patients with end-stage cardiac failure.
PG  - S31-3
AB  - BACKGROUND: Besides standard left ventricular (LV) stimulation via the coronary 
      sinus, a transseptal approach allows left ventricular endocardial stimulation. We 
      report our long-term observations with biventricular stimulation, using a 
      strictly endocardial system for patients presenting with severe congestive heart 
      failure. METHODS: Six patients with nonischemic cardiomyopathy (mean age = 60 +/- 
      9.6 years, women) in New York Heart Association (NYHA) functional class III (n = 
      5) or IV, despite optimal drug therapy, and a mean LV ejection fraction of 24 +/- 
      3%, underwent implantation of biventricular stimulation systems between April 
      1998 and March 1999. All presented with left bundle branch block and an increased 
      LV end-diastolic diameter (mean = 66 +/- 5 mm). In all patients, a bipolar pacing 
      lead was implanted in the lateral LV wall using a direct transseptal approach. 
      After implantation, all patients received oral anticoagulation. RESULTS: QRS 
      duration decreased from 184 +/- 22 ms to 108 +/- 11 ms. NYHA functional class 
      decreased to II in all patients within 1 month. Over a 85 +/- 5 month follow-up, 
      two patients underwent cardiac transplantation, 2 and 4 years after device 
      implantation, respectively; two patients died of end-stage heart failure 4 years 
      after system implantation; and two patients were alive in functional class II. 
      One patient, who experienced syncope due to fast ventricular, underwent 
      implantation of an ICD. One transient ischemic attack occurred in a patient whose 
      anticoagulation was temporarily interrupted. CONCLUSIONS: Long-term endocardial 
      biventricular stimulation via a transseptal approach was safe and effective in 
      this small population. This approach needs to be further compared with 
      conventional epicardial pacing via the coronary sinus.
FAU - Pasquie, J L
AU  - Pasquie JL
AD  - Clinique des Maladies du Coeur et des Vaisseaux, Hopital Arnaud de Villeneuve, 
      Centre Hospitalo-Universitaire de Montpellier, France. 
      jl-pasquie@chu-montpellier.fr
FAU - Massin, F
AU  - Massin F
FAU - Macia, J C
AU  - Macia JC
FAU - Gervasoni, R
AU  - Gervasoni R
FAU - Bortone, A
AU  - Bortone A
FAU - Cayla, G
AU  - Cayla G
FAU - Grolleau, R
AU  - Grolleau R
FAU - Leclercq, F
AU  - Leclercq F
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
EIN - Pacing Clin Electrophysiol. 2007 Nov;30(11):1424
MH  - Aged
MH  - Bundle-Branch Block
MH  - Cardiac Pacing, Artificial/*methods
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Failure/*therapy
MH  - Heart Septum
MH  - Heart Ventricles
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Pacemaker, Artificial
MH  - Treatment Outcome
EDAT- 2007/02/17 09:00
MHDA- 2008/01/19 09:00
CRDT- 2007/02/17 09:00
PHST- 2007/02/17 09:00 [pubmed]
PHST- 2008/01/19 09:00 [medline]
PHST- 2007/02/17 09:00 [entrez]
AID - PACE599 [pii]
AID - 10.1111/j.1540-8159.2007.00599.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2007 Jan;30 Suppl 1:S31-3. doi: 
      10.1111/j.1540-8159.2007.00599.x.