PMID- 18684261
OWN - NLM
STAT- MEDLINE
DCOM- 20081030
LR  - 20080807
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 31
IP  - 8
DP  - 2008 Aug
TI  - Resynchronization: what if the left ventricular lead cannot reach the lateral or 
      posterolateral wall?
PG  - 1041-5
LID - 10.1111/j.1540-8159.2008.01132.x [doi]
AB  - BACKGROUND: The recommended left ventricular (LV) lead position for cardiac 
      resynchronization therapy (CRT) is at the lateral or posterolateral wall. 
      However, LV leads cannot always be implanted at this site. The objective of our 
      study was to compare the clinical response to CRT when the LV lead could be 
      implanted or not at the lateral or posterolateral wall. METHODS: In consecutive 
      patients implanted with a CRT device, we documented the final position achieved 
      by the tip of the LV lead in the left anterior oblique projection. Patients were 
      prospectively followed for 6 months after implantation. They were defined as 
      responders if they were alive, had gained 1 New York Heart Association (NYHA) 
      functional class, and had not been hospitalized for heart failure. RESULTS: The 
      study population consisted of 77 patients (56 men, 71 +/- 10 years, 62 NYHA class 
      III, 15 NYHA class IV). The LV lead was implanted at the lateral or 
      posterolateral wall in 54 patients (group A) and at the anterior or anterolateral 
      wall in 23 patients (group B). At 6 months, seven patients (9%) died (all in 
      group A). There were 37 responders (69%) in group A as compared to 22 (96%) in 
      group B. CONCLUSIONS: The responder rate was not inferior when the LV lead was 
      implanted at the anterior or anterolateral wall. Thus, in case of failed 
      implantation at the lateral or posterolateral wall, positioning the LV lead in a 
      more anterior location appears to be a reasonable alternative. Further studies 
      are required to confirm these findings.
FAU - D'Ivernois, Christophe
AU  - D'Ivernois C
AD  - Service de Cardiologie, Hopital Universitaire Dupuytren, Limoges, France. 
      christophe.divernois@chu-limoges.fr
FAU - Lesage, Jerome
AU  - Lesage J
FAU - Blanc, Patrick
AU  - Blanc P
LA  - eng
PT  - Comparative Study
PT  - Controlled Clinical Trial
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
MH  - *Electrodes, Implanted
MH  - Female
MH  - Heart Failure/*diagnosis/*prevention & control
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Male
MH  - *Pacemaker, Artificial
MH  - Prosthesis Implantation/*methods
MH  - Treatment Outcome
EDAT- 2008/08/08 09:00
MHDA- 2008/10/31 09:00
CRDT- 2008/08/08 09:00
PHST- 2008/08/08 09:00 [pubmed]
PHST- 2008/10/31 09:00 [medline]
PHST- 2008/08/08 09:00 [entrez]
AID - PACE1132 [pii]
AID - 10.1111/j.1540-8159.2008.01132.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2008 Aug;31(8):1041-5. doi: 
      10.1111/j.1540-8159.2008.01132.x.