PMID- 18811806
OWN - NLM
STAT- MEDLINE
DCOM- 20081208
LR  - 20080924
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 31
IP  - 10
DP  - 2008 Oct
TI  - Hemodynamics and prognosis after primary cardiac resynchronization system 
      implantation compared to "upgrade" procedures.
PG  - 1265-71
LID - 10.1111/j.1540-8159.2008.01176.x [doi]
AB  - INTRODUCTION: Left bundle brunch block (LBBB) and right ventricular stimulation 
      (RVS) may be associated with asynchrony and heart failure. Differences between 
      these two entities and their response to cardiac resynchronization therapy (CRT) 
      are not well defined. METHODS: Patients receiving CRT from 1999 to 2006 were 
      analyzed for cardiac events and prognosis separated between primary implants for 
      LBBB (n = 221) and upgrades from RVS (n = 107). A subgroup of 105 patients (LBBB 
      = 69; RVS = 36) was studied in more detail (New York Heart Association [NYHA], 
      quality of life, brain natriuretic peptide, peak VO2, left ventricular ejection 
      fraction [LVEF], wedge pressure, Cardiac Index, QRS, left-right preejection 
      period using pulsed wave doppler, septum-lateral wall motion delay using tissue 
      doppler imaging) at baseline and after 1 year. RESULTS: Age (68.4 +/- 11 years vs 
      68.7 +/- 15 years, n. s.), NYHA class (3.1 vs 3.1, n. s.), LVEF (26.4 vs 28.1, n. 
      s.), and clinical parameters were comparable between LBBB and RVS. The latter 
      group consisted of more patients with chronic atrial fibrillation (14% vs 37%, P 
      = 0.03). After 1 year, NYHA class (-0.8 +/- 0.8 vs -0.6 +/- 0.8, n. s.), LVEF 
      (+13.7 +/- 14% vs +8.7 +/- 10%, n. s.), and clinical parameters improved 
      similarly. After a median follow-up of 2.33 +/- 1.8 years in the LBBB versus 2.43 
      +/- 1.9 years in the RVS group, there was no difference in long-term prognosis or 
      cardiac events in the total cohort (5-year event rate, 53% vs 55%, P = n. s.). 
      CONCLUSION: Upgrade patients showed similar baseline parameters and response to 
      CRT as to primary implants. No difference in events or long-term prognosis could 
      be observed.
FAU - Nagele, Herbert
AU  - Nagele H
AD  - St. Adolfstift, Reinbek, Medical Department, Reinbek, Germany. 
      herbert_naegele@yahoo.de
FAU - Dodeck, Julia
AU  - Dodeck J
FAU - Behrens, Stefan
AU  - Behrens S
FAU - Azizi, Mojgan
AU  - Azizi M
FAU - Hashagen, Sandra
AU  - Hashagen S
FAU - Eisermann, Christine
AU  - Eisermann C
FAU - Castel, Maria A
AU  - Castel MA
LA  - eng
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  - Bundle-Branch Block/*epidemiology/*therapy
MH  - Cardiac Pacing, Artificial/*statistics & numerical data
MH  - Female
MH  - Germany/epidemiology
MH  - Heart Failure/diagnosis/*epidemiology/*prevention & control
MH  - Humans
MH  - Male
MH  - Prevalence
MH  - Prognosis
MH  - Risk Assessment/*methods
MH  - Risk Factors
MH  - Treatment Outcome
EDAT- 2008/09/25 09:00
MHDA- 2008/12/17 09:00
CRDT- 2008/09/25 09:00
PHST- 2008/09/25 09:00 [pubmed]
PHST- 2008/12/17 09:00 [medline]
PHST- 2008/09/25 09:00 [entrez]
AID - PACE1176 [pii]
AID - 10.1111/j.1540-8159.2008.01176.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2008 Oct;31(10):1265-71. doi: 
      10.1111/j.1540-8159.2008.01176.x.