PMID- 20180916
OWN - NLM
STAT- MEDLINE
DCOM- 20101130
LR  - 20100720
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 33
IP  - 7
DP  - 2010 Jul
TI  - Long-term effects of upgrading to biventricular pacing: differences with cardiac 
      resynchronization therapy as primary indication.
PG  - 841-9
LID - 10.1111/j.1540-8159.2010.02701.x [doi]
AB  - BACKGROUND: Few studies have assessed the long-term effects of cardiac 
      resynchronization therapy (CRT) in patients with advanced heart failure (HF) and 
      previously right ventricular apical pacing (RVAP). AIMS: To assess the clinical 
      and hemodynamic impact of upgrading to biventricular pacing in patients with 
      severe HF and permanent RVAP in comparison with patients who had CRT implantation 
      as initial therapy. METHODS AND RESULTS: Thirty-nine patients with RVAP, advanced 
      HF (New York Heart Association [NYHA] III-IV), and severe depression of left 
      ventricular ejection fraction (LVEF) were upgraded to biventricular pacing (group 
      A). Mean duration of RVAP before upgrading was 41.8 +/- 13.3 months. Clinical and 
      echocardiographic results were compared to those obtained in a group of 43 
      patients with left bundle branch block and similar clinical characteristics 
      undergoing "primary" CRT (group B). Mean follow-up was 35 +/- 10 months in 
      patients of group A and 38 +/- 12 months in group B. NYHA class significantly 
      improved in groups A and B. LVEF increased from 0.23 +/- 0.07 to 0.36 +/- 0.09 (P 
      < 0.001) and from 0.26 +/- 0.02 to 0.34 +/- 0.10 (P < 0.001), respectively. 
      Hospitalizations were reduced by 81% and 77% (P < 0.001). Similar improvements in 
      echocardiographic signs of ventricular desynchronization were also observed. 
      CONCLUSION: Patients upgraded to CRT exhibit long-term clinical and hemodynamic 
      benefits that are similar to those observed in patients treated with CRT as 
      initial strategy.
FAU - Paparella, Gaetano
AU  - Paparella G
AD  - Heart Rhythm Management Center, UZ Brussel Vrjie Universiteit Brussel, Brussels, 
      Belgium. ga.pap@libero.it
FAU - Sciarra, Luigi
AU  - Sciarra L
FAU - Capulzini, Lucio
AU  - Capulzini L
FAU - Francesconi, Anna
AU  - Francesconi A
FAU - De Asmundis, Carlo
AU  - De Asmundis C
FAU - Sarkozy, Andrea
AU  - Sarkozy A
FAU - Cazzin, Roberto
AU  - Cazzin R
FAU - Brugada, Pedro
AU  - Brugada P
LA  - eng
PT  - Controlled Clinical Trial
PT  - Journal Article
DEP - 20100218
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  - Equipment Design
MH  - Equipment Failure Analysis
MH  - Female
MH  - Heart Failure/complications/*diagnosis/*prevention & control
MH  - Humans
MH  - Male
MH  - *Pacemaker, Artificial
MH  - Reproducibility of Results
MH  - Sensitivity and Specificity
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/*diagnosis/etiology/*prevention & control
EDAT- 2010/02/26 06:00
MHDA- 2010/12/14 06:00
CRDT- 2010/02/26 06:00
PHST- 2010/02/26 06:00 [entrez]
PHST- 2010/02/26 06:00 [pubmed]
PHST- 2010/12/14 06:00 [medline]
AID - PACE2701 [pii]
AID - 10.1111/j.1540-8159.2010.02701.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2010 Jul;33(7):841-9. doi: 
      10.1111/j.1540-8159.2010.02701.x. Epub 2010 Feb 18.