PMID- 22017475
OWN - NLM
STAT- MEDLINE
DCOM- 20120611
LR  - 20120207
IS  - 1540-8159 (Electronic)
IS  - 0147-8389 (Linking)
VI  - 35
IP  - 2
DP  - 2012 Feb
TI  - Comparison of the efficacy of two surgical alternatives for cardiac 
      resynchronization therapy: trans-apical versus epicardial left ventricular 
      pacing.
PG  - 124-30
LID - 10.1111/j.1540-8159.2011.03239.x [doi]
AB  - BACKGROUND: Epicardial pacing lead implantation is the currently preferred 
      surgical alternative for left ventricular (LV) lead placement. For endocardial LV 
      pacing, we developed a fundamentally new surgical method. The trans-apical lead 
      implantation is a minimally invasive technique that provides access to any LV 
      segments. The aim of this prospective randomized study was to compare the outcome 
      of patients undergoing either trans-apical endocardial or epicardial LV pacing. 
      METHODS: In group I, 11 end-stage heart failure (HF) patients (mean age 59.7 +/- 
      7.9 years) underwent trans-apical LV lead implantation. Epicardial LV leads were 
      implanted in 12 end-stage HF patients (group II; mean age 62.8 +/- 7.3 years). 
      Medical therapy was optimized in all patients. The following parameters were 
      compared during an 18-month follow-up period: LV ejection fraction (LVEF), LV 
      end-diastolic diameter (LVEDD), LV end-systolic diameter, and New York Heart 
      Association (NYHA) functional class. RESULTS: Nine out of 11 patients responded 
      favorably to the treatment in group I (LVEF 39.7 +/- 12.5 vs 26.0 +/- 7.8%, P < 0.01; 
      LVEDD 70.4 +/- 13.6 mm vs 73.7 +/- 10.5 mm, P = 0.002; NYHA class 2.2 +/- 0.4 vs 3.5 +/- 
      0.4, P < 0.01) and eight out of 12 in group II (LVEF 31.5 +/- 11.5 vs 26.4 +/- 8.9%, 
      P = < 0.001; NYHA class 2.7 +/- 0.4 vs 3.6 +/- 0.4, P < 0.05). During the follow-up 
      period, one patient died in group I and three in group II. There was one 
      intraoperative LV lead dislocation in group I and one early postoperative 
      dislocation in each group. None of the patients developed thromboembolic 
      complications. CONCLUSIONS: Our data suggest that trans-apical endocardial LV 
      lead implantation is an alternative to epicardial LV pacing.
CI  - (c)2011, The Authors. Journal compilation (c)2012 Wiley Periodicals, Inc.
FAU - Mihalcz, Attila
AU  - Mihalcz A
AD  - Department of Electrophysiology, Gottsegen Gyorgy Hungarian Institute of 
      Cardiology, Budapest, Hungary.
FAU - Kassai, Imre
AU  - Kassai I
FAU - Kardos, Attila
AU  - Kardos A
FAU - Foldesi, Csaba
AU  - Foldesi C
FAU - Theuns, Dominic
AU  - Theuns D
FAU - Szili-Torok, Tamas
AU  - Szili-Torok T
LA  - eng
PT  - Comparative Study
PT  - Journal Article
PT  - Randomized Controlled Trial
DEP - 20111020
PL  - United States
TA  - Pacing Clin Electrophysiol
JT  - Pacing and clinical electrophysiology : PACE
JID - 7803944
SB  - IM
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Cardiac Resynchronization Therapy Devices
MH  - *Electrodes, Implanted
MH  - Endocardium/*surgery
MH  - Female
MH  - Heart Failure/complications/diagnosis/*prevention & control
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Pericardium/*surgery
MH  - Prosthesis Implantation/*methods
MH  - Treatment Outcome
MH  - Ventricular Dysfunction, Left/complications/diagnosis/*prevention & control
EDAT- 2011/10/25 06:00
MHDA- 2012/06/12 06:00
CRDT- 2011/10/25 06:00
PHST- 2011/10/25 06:00 [entrez]
PHST- 2011/10/25 06:00 [pubmed]
PHST- 2012/06/12 06:00 [medline]
AID - 10.1111/j.1540-8159.2011.03239.x [doi]
PST - ppublish
SO  - Pacing Clin Electrophysiol. 2012 Feb;35(2):124-30. doi: 
      10.1111/j.1540-8159.2011.03239.x. Epub 2011 Oct 20.