PMID- 24238501
OWN - NLM
STAT- MEDLINE
DCOM- 20140514
LR  - 20220311
IS  - 2542-5641 (Electronic)
IS  - 0366-6999 (Linking)
VI  - 126
IP  - 22
DP  - 2013 Nov
TI  - Utility of echocardiographic tissue synchronization imaging to redirect left 
      ventricular epicardial lead placement for cardiac resynchronization therapy.
PG  - 4222-6
AB  - BACKGROUND: Cardiac resynchronization therapy (CRT) with biventricular pacing has 
      demonstrated cardiac function improvement for treating congestive heart failure 
      (HF). It has been documented that the placement of the left ventricular lead at 
      the longest contraction delay segment has the optimal CRT benefit. This study 
      described follow-up to surgical techniques for CRT as a viable alternative for 
      patients with heart failure. METHODS: Between April 2007 and June 2012, a total 
      of 14 consecutive heart failure patients with New York Heart Association (NYHA) 
      Class III-IV underwent left ventricular epicardial lead placements via surgical 
      approach. There were eight males and six females, aged 36 to 79 years ((59.6 +/- 
      9.2) years). The mean left ventricular ejection fraction (LVEF) was (33.6 +/- 
      7.4)%. All patients were treated with left ventricular systolic dyssynchrony and 
      underwent left ventricular epicardial lead placements via a surgical approach. 
      Tissue Doppler imaging (TDI) and intraoperative transesophageal echocardiography 
      were used to assess changes in left heart function and dyssynchronic parameters. 
      Also, echo was used to select the best site for left ventricular epicardial lead 
      placement. RESULTS: Left ventricular epicardial leads were successfully implanted 
      in the posterior or lateral epicardial wall without serious complications in all 
      patients. All patients had reduction in NYHA score from III-IV preoperatively to 
      II-III postoperatively. The left ventricular end-diastolic diameter (LVEDD) 
      decreased from (67.9 +/- 12.7) mm to (61.2 +/- 7.1) mm (P < 0.05), and LVEF increased 
      from (33.6 +/- 7.4)% to (42.2 +/- 8.8)% (P < 0.05). Left ventricular intraventricular 
      dyssynchrony index decreased from (148.4 +/- 31.6) ms to (57.3 +/- 23.8) ms (P < 
      0.05). CONCLUSIONS: Minimally invasive surgical placement of the left ventricular 
      epicardial lead is feasible, safe, and efficient. TDI can guide the epicardial 
      lead placement to the ideal target location.
FAU - Zhang, Ye
AU  - Zhang Y
AD  - Department of Echo, Beijing Anzhen Hospital, Capital Medical University, Beijing 
      Institute of Heart, Lung and Blood Vessel Diseases, Beijing 100029, China.
FAU - Li, Zhi-An
AU  - Li ZA
FAU - He, Yi-Hua
AU  - He YH
FAU - Zhang, Hai-Bo
AU  - Zhang HB
FAU - Meng, Xu
AU  - Meng X
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PL  - China
TA  - Chin Med J (Engl)
JT  - Chinese medical journal
JID - 7513795
SB  - IM
MH  - Adult
MH  - Aged
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Echocardiography/*methods
MH  - Female
MH  - Heart Failure/therapy
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
EDAT- 2013/11/19 06:00
MHDA- 2014/05/16 06:00
CRDT- 2013/11/19 06:00
PHST- 2013/11/19 06:00 [entrez]
PHST- 2013/11/19 06:00 [pubmed]
PHST- 2014/05/16 06:00 [medline]
PST - ppublish
SO  - Chin Med J (Engl). 2013 Nov;126(22):4222-6.