PMID- 31778999
OWN - NLM
STAT- MEDLINE
DCOM- 20200930
LR  - 20200930
IS  - 1421-9751 (Electronic)
IS  - 0008-6312 (Linking)
VI  - 145
IP  - 1
DP  - 2020
TI  - Merits of Different Ventricular Lead Locations on Left Ventricular Myocardial 
      Strain and Dyssynchrony in Patients with Cardiac Resynchronization Therapy.
PG  - 13-20
LID - 10.1159/000503953 [doi]
AB  - BACKGROUND: The idea behind cardiac resynchronization therapy (CRT) is to pace 
      both ventricles resulting in a synchronized electro-mechanical coupling of the 
      left ventricle (LV), meaning every effort should be made to improve the 
      percentage of CRT responders. OBJECTIVES: This study aimed at demonstrating the 
      short-term effect of right ventricular apical (RVA) and mid-septal (RVS) lead 
      locations combined with different LV lead positions on LV myocardial strain, 
      dyssynchrony, and clinical outcomes. METHODS: We examined 60 patients with 
      indication for CRT before and after 6 months of implantation for clinical outcome 
      and CRT response (6-min walk test [6MWT], NYHA class, decrease in left 
      ventricular end systolic volume [LVESV] by >15%), dyssynchrony, and myocardial 
      strain. RESULTS: After 6 months of follow-up, the two RV lead locations 
      represented a significant improvement in 6MWT, left ventricular ejection 
      fraction, and LVESV in comparison to baseline values, but no significant 
      difference was found between both groups. With regards to NYHA class improvement, 
      p values were insignificant between the groups (0.44 and 0.88) at baseline and 6 
      months after implantation, respectively. The mean 6MWT was 273.8 m in the RVA 
      group compared to 279.0 m in the RVS group (p = 0.84) at baseline. After 6 months 
      of CRT implantation, the 6MWT mean was 326.5 m in the RVA group compared to 316.2 
      m in the RVS group (p = 0.74). The posterolateral cardiac vein site showed a 
      significant improvement when combined with RVS location in interventricular and 
      intraventricular dyssynchrony, global longitudinal strain, global circumferential 
      strain, and apical circumferential strain (p = 0.01 0.032, 0.02, 0.005, and 
      0.049), respectively. CONCLUSION: RVS is not inferior and provides a good 
      alternative to RVA pacing in short-term follow-up. However, the QRS duration, 
      myocardial strain, and dyssynchrony varies depending on RV and LV stimulation 
      sites. Long-term morbidity and mortality outcomes according to LV lead location 
      in coronary sinus need more assessment.
CI  - (c) 2019 S. Karger AG, Basel.
FAU - Algazzar, Alaa S
AU  - Algazzar AS
AD  - Division of Cardiology, Department of Medicine, King Abdulaziz University, 
      Jeddah, Saudi Arabia, goodminds@hotmail.com.
FAU - Elbably, Mohamed M
AU  - Elbably MM
AD  - National Heart Institute, Cairo, Egypt.
FAU - Katta, Azza A
AU  - Katta AA
AD  - National Heart Institute, Cairo, Egypt.
FAU - Elmeligy, Neama
AU  - Elmeligy N
AD  - Cardiology Department, Banha University, Banha, Egypt.
FAU - Elrabbat, Khaled
AU  - Elrabbat K
AD  - Cardiology Department, Banha University, Banha, Egypt.
FAU - Qutub, Mohammed A
AU  - Qutub MA
AD  - Division of Cardiology, Department of Medicine, King Abdulaziz University, 
      Jeddah, Saudi Arabia.
LA  - eng
PT  - Journal Article
DEP - 20191128
PL  - Switzerland
TA  - Cardiology
JT  - Cardiology
JID - 1266406
SB  - IM
MH  - Aged
MH  - Cardiac Resynchronization Therapy/*methods
MH  - Echocardiography
MH  - *Electrodes, Implanted
MH  - Female
MH  - Heart Failure/physiopathology/*therapy
MH  - Heart Ventricles/*surgery
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Prosthesis Implantation/methods
MH  - Treatment Outcome
MH  - Walk Test
OTO - NOTNLM
OT  - Apical circumferential strain
OT  - Cardiac resynchronization therapy
OT  - Dyssynchrony
OT  - Global circumferential strain
OT  - Global longitudinal strain
OT  - Right ventricular apical pacing
OT  - Right ventricular septal pacing
EDAT- 2019/11/30 06:00
MHDA- 2020/10/02 06:00
CRDT- 2019/11/29 06:00
PHST- 2019/02/20 00:00 [received]
PHST- 2019/10/07 00:00 [accepted]
PHST- 2019/11/30 06:00 [pubmed]
PHST- 2020/10/02 06:00 [medline]
PHST- 2019/11/29 06:00 [entrez]
AID - 000503953 [pii]
AID - 10.1159/000503953 [doi]
PST - ppublish
SO  - Cardiology. 2020;145(1):13-20. doi: 10.1159/000503953. Epub 2019 Nov 28.