PMID- 32847323
OWN - NLM
STAT- MEDLINE
DCOM- 20200924
LR  - 20200924
IS  - 0253-3758 (Print)
IS  - 0253-3758 (Linking)
VI  - 48
IP  - 8
DP  - 2020 Aug 24
TI  - [Application and efficacy of the adjustment on left ventricular electrical delay 
      and the distance between right and left ventricular pacing polar in optimizing 
      the left ventricular pacing polar].
PG  - 669-674
LID - 10.3760/cma.j.cn112148-20200227-00132 [doi]
AB  - Objective: To investigate the application and efficacy of left ventricular (LV) 
      electrical delay (LVED) and the distance of right ventricular(RV) pacing polar to 
      LV(DRLV) in optimizing LV pacing polar. Methods: Heart failure (HF) patients who 
      implanted cardiac resynchronization therapy (CRT) device with a LV quadripolar 
      lead from January 2014 to January 2018 at General Hospital of Northern Theater 
      Command were enrolled in the study. Measurements of LVED and DRLV of each polar 
      of the lead were performed in patients with HF who underwent CRT with LV 
      quadripolar lead. The principle in turn for polar selecting used for clinical LV 
      pacing was the pacing polar: (1)without phrenic nerve stimulation(PNS); (2)with 
      appropriate capture threshold; (3)not located in apical; (4)with maximal LVED; 
      (5)with maximal DRLV. The LV pacing polar was selected for CRT according to the 
      procedure. The distribution of target veins implanted with LV quadripolar lead 
      were calculated. The percentage of biventricular pacing at 6-month follow-up was 
      recorded. The following indexes were compared before and 6-month after surgery, 
      including QRS duration, LV end-systolic volume(LVESV), LV ejection 
      fraction(LVEF), LV end-diastolic dimension(LVEDD), 6 minute walking 
      distance(6MWD), New York Heart Association(NYHA) class. The efficacy and 
      echocardiographic efficacy of CRT was evaluated. Results: There were twenty-nine 
      HF patients enrolled. The mean age of enrolled patients was(61.7+/-7.6)years old, 
      nineteen (66%)of them were male. There were seventeen(59%) patients diagnosed as 
      dilated cardiomyopathy and twelve(41%) patients as ischemic cardiomyopathy. All 
      patients were successfully implanted with LV quadripolar lead into target veins, 
      and all four pacing sites were also in target veins. Target veins were located in 
      lateral veins in 15 patients (52%), anterior veins in 2 patients (7%), posterior 
      veins in 11 patients (38%), and lateral branches of great cardiac veins in 1 
      patient (3%). After 6-month of follow-up, the percentage of biventricular pacing 
      was greater than 95%.There were nineteen(66%) patients optimized LV pacing polar 
      by the largest LVED and four (14%) patients by the DRLV. Of the 29 patients, 
      5(17%) patients used D1 as the pacing polar, 5(17%) patients used M2 as the 
      pacing polar, 7(24%) patients used M3 as the pacing polar, and 12(41%) patients 
      used P4 as the pacing polar. The pacing polars (D1, M2) of traditional bipolar 
      lead were used in 10(34%) patients, and the LV quadripolar lead specific pacing 
      polars (M3, P4) were used in 19(66%) patients.Compared to a LV quadripolar lead, 
      the LV pacing polar (M3, P4) selected in 19(66%) patients were not achievable 
      with the traditional LV bipolar lead (D1, M2). Preoperative QRS duration, LVESV, 
      LVEF, LVEDD, 6MWD and NYHA class were (171+/-24)ms, (231+/-79)ml, (28+/-5)%, (74+/-11)mm, 
      (294+/-103)m, (3.2+/-1.0)class and the postoperative 6-month were (130+/-12)ms, 
      (158+/-73)ml, (36+/-10)%, (66+/-12)mm, (371+/-86)m, (1.9+/-0.5)class. These indexes were 
      significantly improved after 6 months operation(P<0.001). 97% and 83% patients 
      were responders of CRT as assessed by 6-month efficacy and echocardiographic 
      efficacy. Conclusion: The maximal LVED and DRLV can be used to select LV pacing 
      polar with a high rate of CRT response rate.
FAU - Yan, X L
AU  - Yan XL
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 
      110016, China.
FAU - Liang, Y C
AU  - Liang YC
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 
      110016, China.
FAU - Yu, H B
AU  - Yu HB
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 
      110016, China.
FAU - Xu, B G
AU  - Xu BG
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 
      110016, China.
FAU - Gao, Y
AU  - Gao Y
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 
      110016, China.
FAU - Liu, R
AU  - Liu R
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 
      110016, China.
FAU - Xu, G Q
AU  - Xu GQ
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 
      110016, China.
FAU - Wu, M
AU  - Wu M
AD  - Department of Cardiology, General Hospital of Northern Theater Command, Shenyang 
      110016, China.
LA  - chi
GR  - 2016YFC0900904, 2016YFC0900905/National Key Research and Development Program/
PT  - Journal Article
PL  - China
TA  - Zhonghua Xin Xue Guan Bing Za Zhi
JT  - Zhonghua xin xue guan bing za zhi
JID - 7910682
SB  - IM
MH  - Aged
MH  - *Cardiac Resynchronization Therapy
MH  - Heart Failure/*therapy
MH  - Heart Ventricles
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Treatment Outcome
MH  - Ventricular Function, Left
OTO - NOTNLM
OT  - Cardiac pacing
OT  - Cardiac resynchronization therapy
OT  - Lead
OT  - Left ventricular
EDAT- 2020/08/28 06:00
MHDA- 2020/09/25 06:00
CRDT- 2020/08/28 06:00
PHST- 2020/08/28 06:00 [entrez]
PHST- 2020/08/28 06:00 [pubmed]
PHST- 2020/09/25 06:00 [medline]
AID - 10.3760/cma.j.cn112148-20200227-00132 [doi]
PST - ppublish
SO  - Zhonghua Xin Xue Guan Bing Za Zhi. 2020 Aug 24;48(8):669-674. doi: 
      10.3760/cma.j.cn112148-20200227-00132.