Long-term Results of Surgical Lead Implantation for Biventricular Pacemakers in Cardiomyopathy Patients
DOI:
https://doi.org/10.1532/HSF98.20061171Abstract
Patients with congestive heart failure commonly display dysynchronous contraction patterns and weakened cardiac performance. Cardiac resynchronization therapy from biventricular pacing has been proven effective using coronary sinus cannulation or a less common surgical approach. In this study, the beneficial effects of implanting biventricular leads using the surgical approach for New York Heart Association functional class 3 or 4 patients (mean, 3.4 ± 0.5) were evaluated in 19 patients (17 male, 2 female). Pacing thresholds after 2 years were deemed favorable (left ventricle, 2.1 ± 0.8 V; right ventricle, 1.1 ± 0.4 V). Dobutamine therapy was no longer needed in 2 patients after they underwent biventricular pacing. No mortality or morbidity resulted from the procedure, and 2 patients were readmitted to the hospital, once each after the procedure over the 2-year follow-up period. The data show that the surgical approach for cardiac resynchronization therapy has durable long-term results.References
Abraham W, Fisher W, Smith A, et al. 2002. Cardiac resynchronization in chronic heart failure. N Engl J Med 346:1845-53.nAlonso C, Leclercq C, Revault d'Allonnes F, et al. 2001. Six year experience of transvenous left ventricular lead implantation for permanent biventricular pacing in patients with advanced heart failure: technical aspects. Heart 86:405-10.nCazeau S, Leclerq C, Lavergne T, et al. 2002. Effects of multisite biventricular pacing in patients with heart failure and intraventricular conduction delay. N Engl J Med 344:873-80.nCazeau C, Ritter P, Lazarus A, et al. 1996. Multisite pacing for end-stage heart failure: early experience. PACE 19:1748-57nDaubert J, Ritter P, LeBreton H. 1998. Permanent left ventricular pacing with transvenous leads inserted into the coronary sinus. PACE 21:239-45.nHarostock M, McDonnell B, Briskie J. 2002. Advantages to the surgical approach for biventricular pacemaker implantation in cardiomyopathy patients. Scientific Forum Annual Meeting of the Pennsylvania Association for Thoracic Surgery. October 2002.nNavia J, Atik F, Grimm R, et al. 2005. Minimally invasive left ventricular epicardial lead placement: surgical techniques for heart failure resynchronization therapy. Ann Thorac Surg 79:1536-44.nReuter S, Garrigue S, Barold S, et al. 2002. Comparison of characteristics in responders versus nonresponders with biventricular pacing for drugresistant congestive heart failure. Am J Cardiol 89:346-50.nWalker S, Levy T, Rex S, Brant S, Paul V. 2000. Initial United Kingdom experience with the use of permanent, biventricular pacemakers. Europace 2:233-9.nYu C, Chau E, Sanderson J, et al. 2002. Tissue doppler echocardiographic evidence of reverse remodeling and improved synchronicity by simultaneously delaying regional contraction after biventricular pacing therapy in heart failure. Circulation 105:438-55.n
