1. Stimularea bifocală ventriculară dreaptă ca alternativă a stimulării biventriculare în resincronizarea cardiacă.
- Author
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Roşianu, Ş. H., Beyer, Ruxandra, and Căpâlneanu, R.
- Subjects
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HEART failure , *VENTRICULAR fibrillation , *ELECTROCARDIOGRAPHY , *ATRIAL fibrillation diagnosis , *CONTRACTILITY (Biology) , *PHYSIOLOGY - Abstract
Introduction – Cardiac resynchronization therapy (CRT) is an additional therapeutic method in patients with advanced drug refractory heart failure (HF). In 10% of cases because of the unsuitable anatomy it is impossible to place the coronary sinus lead in the poster lateral vein. Objectives – To compare the effects of the bifocal right ventricular pacing (BFRVP) with those of the biventricular pacing (BVP) on the basis of clinical, ECG and echocardiographic parameters. Material and methods – 22 patients in NYHA class III or IV, large QRS, in sinus rhythm or in atrial fibrillation, with ejection fraction (EF) < 35%, drug refractory HF and CRT indication.17 patients (77, 27 %) with BVP and 5 patients (22,72 %) with BFRVP. The clinical (NYHA class, 6 min walk test), ECG (the BFRVP QRS duration/native duration) and echocardiographic (ejection fraction – EF, SPWMD) parameters were assessed and compared prior to implantation, at 3 and 6 month follow-up. Results – Compared with baseline the NYHA class (I and II post implantation vs. III and IV pre implantation) and the effort capacity (250, 72 ± 38,43m preprocedural vs. 319, 54 ± 54,27m postprocedural, p ≤ 0.0001) at 3 and 6 month respectively improved in all patients. The QRS bifocal paced was narrower than the native one, especially more narrow than the apical or RVOT exclusively paced complex. The BFRVP mildly improved the EF and the SPWMD. Conclusions – 1. The BFRVP determine a signifi cant reduction in ventricular dissynchronism and the improvement of contractility. 2. The BFRVP represents a therapeutic alternative in patients with CRT indication in which the attempt to place the coronary sinus lead fails. [ABSTRACT FROM AUTHOR]
- Published
- 2011