PMID- 17725752
OWN - NLM
STAT- MEDLINE
DCOM- 20071218
LR  - 20070829
IS  - 0147-8389 (Print)
IS  - 0147-8389 (Linking)
VI  - 30
IP  - 9
DP  - 2007 Sep
TI  - Biventricular upgrading in patients with conventional pacing system and 
      congestive heart failure: results and response predictors.
PG  - 1096-104
AB  - BACKGROUND: There are few studies on cardiac resynchronization therapy (CRT) in 
      heart failure (HF) patients with preexisting right ventricular (RV) pacing. The 
      purpose of this study was to determine the efficacy of CRT upgrading in RV-paced 
      patients and the predictivity of electromechanical dyssynchrony parameters (EDP) 
      evaluated by standard echocardiography (ECHO) and tissue Doppler imaging (TDI). 
      METHODS: Thirty-eight consecutive patients with HF [New York Heart Association 
      (NYHA) class III or IV, LVEF < 35%], prior continuous RV pacing, and absence of 
      atrial fibrillation were enrolled in the presence of a paced QRS > or = 150 ms 
      and evaluated by ECHO and TDI. A responder was defined as a patient with a 
      favorable change in NYHA class and neither HF hospitalization nor death, plus an 
      absolute increase of LVEF > or = 10 units. RESULTS: At six-months follow-up, the 
      whole study population had significant improvement in symptoms, systolic 
      function, and QRS duration (P < 0.001); 32 (84%) patients had a favorable 
      clinical outcome, 25 (66%) were considered responders according to the previous 
      definition. Postimplant QRS was similarly reduced in both responders and 
      nonresponders, whereas EDP had a significant improvement only in responders (P < 
      0.05). Using EDP, 23 (79%) patients were responders compared with 2 (22%) 
      patients without mechanical dyssynchrony (P = 0.002). CONCLUSIONS: In HF patients 
      with previous RV pacing, CRT is effective to improve clinical, functional 
      outcome, and LV performance and to reduce electromechanical dyssynchrony in a 
      large proportion of patients. Dyssynchrony evaluated by standard and TDI ECHO can 
      be useful for CRT selection of paced patients.
FAU - Laurenzi, Francesco
AU  - Laurenzi F
AD  - S. Camillo Hospital, Rome, Italy. laurenzi.f@tiscali.it
FAU - Achilli, Augusto
AU  - Achilli A
FAU - Avella, Andrea
AU  - Avella A
FAU - Peraldo, Carlo
AU  - Peraldo C
FAU - Orazi, Serafino
AU  - Orazi S
FAU - Perego, Giovanni B
AU  - Perego GB
FAU - Cesario, Antonio
AU  - Cesario A
FAU - Valsecchi, Sergio
AU  - Valsecchi S
FAU - De Santo, Tiziana
AU  - De Santo T
FAU - Puglisi, Andrea
AU  - Puglisi A
FAU - Tondo, Claudio
AU  - Tondo C
LA  - eng
PT  - Clinical Trial
PT  - Journal Article
PT  - Multicenter Study
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods
MH  - Electrocardiography/*methods
MH  - Female
MH  - Heart Failure/complications/*diagnosis/*prevention & control
MH  - Humans
MH  - Italy
MH  - Male
MH  - Prognosis
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
MH  - Ventricular Fibrillation/complications/*diagnosis/*prevention & control
EDAT- 2007/08/30 09:00
MHDA- 2007/12/19 09:00
CRDT- 2007/08/30 09:00
PHST- 2007/08/30 09:00 [pubmed]
PHST- 2007/12/19 09:00 [medline]
PHST- 2007/08/30 09:00 [entrez]
AID - PACE819 [pii]
AID - 10.1111/j.1540-8159.2007.00819.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2007 Sep;30(9):1096-104. doi: 
      10.1111/j.1540-8159.2007.00819.x.