PMID- 21039639
OWN - NLM
STAT- MEDLINE
DCOM- 20110421
LR  - 20101207
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 33
IP  - 12
DP  - 2010 Dec
TI  - Greater three-dimensional ventricular lead tip separation is associated with 
      improved outcome after cardiac resynchronization therapy.
PG  - 1490-6
LID - 10.1111/j.1540-8159.2010.02895.x [doi]
AB  - BACKGROUND: Effective cardiac resynchronization therapy (CRT) is more likely with 
      widely separated left ventricular (LV) and right ventricular (RV) pacing leads 
      tips. We hypothesized that lead separation is an important factor in determining 
      the clinical response to CRT. METHODS: A retrospective study of 86 consecutive 
      patients age 71 +/- 10 years, male (74%), coronary disease (71%), atrial 
      fibrillation (23%), LV ejection fraction (22 +/- 9%), QRS duration (160 +/- 27 ms), 
      New York Heart Association (NYHA) class III (81%), NYHA class IV (19%) undergoing 
      CRT from January 2006 to September 2008. The median follow-up was 12 months and 
      clinical response to CRT was defined as reduction of NYHA class by one or more. 
      The three-dimensional separation between RV and LV pacing lead tips was 
      calculated using measurements obtained from orthogonal posteroanterior and 
      lateral chest radiographs performed the day after implantation. RESULTS: 
      Fifty-nine patients (69%) responded to CRT. There was a statistically significant 
      association between increased three-dimensional lead separation and clinical 
      response to CRT (P= 0.005). Stronger association was obtained when lead 
      separation was corrected for cardiac size (P= 0.001). A significantly higher 
      response rate of 88% was achieved in patients with QRS duration of 160 ms or 
      more, and lead separation of 100 mm or more compared with 60% when lead 
      separation was less than 100 mm and QRS duration remained the same (P = 0.027). 
      CONCLUSIONS: Greater three-dimensional separation of LV-to-RV leads is associated 
      with improved response to CRT. A prospective multicenter trial is needed to 
      assess lead separation as a predictor for response.
CI  - (c)2010, The Authors. Journal compilation (c)2010 Wiley Periodicals, Inc.
FAU - Ariga, Rina
AU  - Ariga R
AD  - Department of Cardiology, Imperial College Healthcare NHS Trust, Hammersmith 
      Hospital, London, United Kingdom. rina.ariga@doctors.org.uk
FAU - Tayebjee, Muzahir H
AU  - Tayebjee MH
FAU - Benfield, Anne
AU  - Benfield A
FAU - Todd, Michelle
AU  - Todd M
FAU - Lefroy, David C
AU  - Lefroy DC
LA  - eng
PT  - Journal Article
DEP - 20101008
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Aged
MH  - Aged, 80 and over
MH  - Atrial Fibrillation/therapy
MH  - *Cardiac Resynchronization Therapy
MH  - Coronary Disease/therapy
MH  - *Electrodes, Implanted
MH  - Female
MH  - Heart Diseases/*therapy
MH  - Heart Failure/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Retrospective Studies
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/therapy
EDAT- 2010/11/03 06:00
MHDA- 2011/04/22 06:00
CRDT- 2010/11/03 06:00
PHST- 2010/11/03 06:00 [entrez]
PHST- 2010/11/03 06:00 [pubmed]
PHST- 2011/04/22 06:00 [medline]
AID - 10.1111/j.1540-8159.2010.02895.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2010 Dec;33(12):1490-6. doi: 
      10.1111/j.1540-8159.2010.02895.x. Epub 2010 Oct 8.