PMID- 18688701
OWN - NLM
STAT- MEDLINE
DCOM- 20090303
LR  - 20211020
IS  - 1383-875X (Print)
IS  - 1383-875X (Linking)
VI  - 23
IP  - 3
DP  - 2008 Dec
TI  - Relationship between left ventricular lead position using a simple radiographic 
      classification scheme and long-term outcome with resynchronization therapy.
PG  - 219-27
LID - 10.1007/s10840-008-9287-1 [doi]
AB  - BACKGROUND: Benefit from cardiac resynchronization therapy (CRT) is likely 
      influenced by the location of the left ventricular (LV) lead. PURPOSE: To 
      evaluate the association of LV lead position with outcome after CRT. METHODS: 
      Two-hundred and fifty patients with LV dysfunction, New York Heart Association 
      (NYHA) class III (68%) or IV (32%) symptoms, and QRS durations > or =120 ms were 
      followed for a median of 30 months post-CRT. LV lead position was categorized as 
      anterior (n = 20, 8%), lateral (n = 128, 51%), or posterior (n = 102; 41%) using 
      postero-anterior and lateral postoperative chest radiographs. RESULTS: Median age 
      was 69 years and most (68%) had ischemic LV dysfunction. Clinical response, 
      defined by a > or =1 NYHA class reduction, was lower in patients with an anterior 
      (30%) versus lateral (76%) or posterior (73%) lead position (p = 0.001). An 
      anterior versus nonanterior position was independently associated with a two to 
      three-fold higher risk for nonresponse to CRT, cardiovascular death, death from 
      worsening heart failure or cardiac transplantation, and death from any cause. 
      Repositioning of the LV lead from an anterior to a nonanterior position in seven 
      patients who had not clinically responded to CRT after > or =6 months resulted in 
      clinical improvement in all cases. CONCLUSIONS: An anterior versus nonanterior LV 
      lead position is independently associated with an increased likelihood of 
      nonresponse to CRT and a higher risk of serious outcomes. Repositioning of an 
      anteriorly placed LV lead to a nonanterior position should be considered in CRT 
      nonresponders.
FAU - Wilton, Stephen B
AU  - Wilton SB
AD  - Libin Cardiovascular Institute of Alberta, University of Calgary, Canada.
FAU - Shibata, Mariko A
AU  - Shibata MA
FAU - Sondergaard, Rachel
AU  - Sondergaard R
FAU - Cowan, Karen
AU  - Cowan K
FAU - Semeniuk, Lisa
AU  - Semeniuk L
FAU - Exner, Derek V
AU  - Exner DV
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080808
PL  - Netherlands
TA  - J Interv Card Electrophysiol
JT  - Journal of interventional cardiac electrophysiology : an international journal of 
      arrhythmias and pacing
JID - 9708966
SB  - IM
MH  - Aged
MH  - Cardiac Pacing, Artificial/*methods
MH  - Disease Progression
MH  - Electrodes, Implanted
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prognosis
MH  - Radiography
MH  - Statistics, Nonparametric
MH  - Ventricular Dysfunction, Left/*diagnostic 
      imaging/mortality/physiopathology/*therapy
EDAT- 2008/08/09 09:00
MHDA- 2009/03/04 09:00
CRDT- 2008/08/09 09:00
PHST- 2008/04/01 00:00 [received]
PHST- 2008/06/02 00:00 [accepted]
PHST- 2008/08/09 09:00 [pubmed]
PHST- 2009/03/04 09:00 [medline]
PHST- 2008/08/09 09:00 [entrez]
AID - 10.1007/s10840-008-9287-1 [doi]
PST - ppublish
SO  - J Interv Card Electrophysiol. 2008 Dec;23(3):219-27. doi: 
      10.1007/s10840-008-9287-1. Epub 2008 Aug 8.