PMID- 17338715
OWN - NLM
STAT- MEDLINE
DCOM- 20070501
LR  - 20071115
IS  - 0147-8389 (Print)
IS  - 0147-8389 (Linking)
VI  - 30
IP  - 2
DP  - 2007 Feb
TI  - The benefits of biventricular pacing in heart failure patients with narrow QRS, 
      NYHA class II and right ventricular pacing.
PG  - 193-8
AB  - OBJECTIVE: To identify subgroups of heart failure patients who might benefit from 
      biventricular pacing. BACKGROUND: Cardiac resynchronization therapy (CRT) 
      improves the quality of life, New York Heart Association (NYHA) functional class, 
      and exercise capacity and decreases hospitalizations for heart failure for 
      patients who have severe heart failure and a wide QRS. It is unclear if other 
      populations of heart failure patients would benefit from CRT. METHODS: One 
      hundred forty-four consecutive heart failure patients who underwent CRT and 
      completed 3 months of follow-up were reviewed. Demographic, echocardiographic, 
      electrocardiographic, and clinical outcome data were analyzed to assess the 
      relationship of functional class and QRS duration before device implantation to 
      postimplant outcomes. RESULTS: There were 20, 88, and 36 patients in NYHA 
      functional class II, III, and IV, respectively. Thirty-four patients had right 
      ventricular pacing and another 29 patients had a QRS duration < or = 150 ms. 
      Patients who were in NYHA functional class II at baseline had significant 
      improvement in left ventricular ejection fraction and indices of left ventricular 
      remodeling after CRT. Similar significant findings were seen in the subgroup with 
      right ventricular pacing at baseline after CRT. However, in the subgroup with a 
      narrow QRS duration, there were no significant changes in the indices of left 
      ventricular remodeling or in the NYHA functional class and there was a 
      significant increase in the QRS duration. For the study cohort as a whole, an 
      improvement in NYHA functional class after CRT correlated with a significant 
      decrease in adverse clinical outcomes. CONCLUSIONS: Heart failure patients who 
      were in NYHA functional class II and those with right ventricular pacing appeared 
      to benefit from CRT.
FAU - Ng, Kenneth
AU  - Ng K
AD  - Division of Medicine, Department of Cardiovascular Medicine, The Cleveland 
      Clinic, Cleveland, Ohio, USA.
FAU - Kedia, Navin
AU  - Kedia N
FAU - Martin, David
AU  - Martin D
FAU - Tchou, Patrick
AU  - Tchou P
FAU - Natale, Andrea
AU  - Natale A
FAU - Wilkoff, Bruce
AU  - Wilkoff B
FAU - Starling, Randall
AU  - Starling R
FAU - Grimm, Richard A
AU  - Grimm RA
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods/*statistics & numerical data
MH  - Comorbidity
MH  - Female
MH  - Heart Failure/*epidemiology/*prevention & control
MH  - *Heart Ventricles
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Ohio/epidemiology
MH  - Prevalence
MH  - Retrospective Studies
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*epidemiology/*prevention & control
EDAT- 2007/03/07 09:00
MHDA- 2007/05/02 09:00
CRDT- 2007/03/07 09:00
PHST- 2007/03/07 09:00 [pubmed]
PHST- 2007/05/02 09:00 [medline]
PHST- 2007/03/07 09:00 [entrez]
AID - PACE649 [pii]
AID - 10.1111/j.1540-8159.2007.00649.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2007 Feb;30(2):193-8. doi: 
      10.1111/j.1540-8159.2007.00649.x.