Yuxiao Zhang
PLA General Hospital, China
Title: RVOT and posterior-lateral LV pacing match improvies biventricular resynchronization in patients with dilated cardiomyopathy
Biography
Biography: Yuxiao Zhang
Abstract
Objective Evaluate the efficacy of biventricular lead location match on cardiac resynchrinization.
Methods Consecutive patients with dilated cardiomyopathy who candidate to CRTD were enrolled into the study. After posterior-lateral lead was implanted, patients were randomized into right ventricular apex match pacing group (RVA) and right ventricular output tract match pacing group (RVT). Active screw-in leads were anchored on the endocardial wall of RVA and RVOT respectively. Physiocurve CRTD generaters (Medtronic Co.) were connected and optimal working parameters were adjusted by ECG and echocardiography. Regular follow up was conducted in clinic for more than 6 months. NYHA class decrease, 6MWD increase, EF increase, BNP level decrease and QRS width decrease were compared between RVA and RVT groups.
Results Fifty patients were enrolled into the study. Four patients were excluded for LV lead location. Forty-six patients (92%, 56.3+-5.7 yrs, male 27) were randomized into RVA group (22, 56.1+-5.3 yrs, male13) and RVT group (24, 56.5+-5.9 yrs, male 14). All procedures were successful wihout conplications. At the follow up of 11.3+-4.7 months, the resynchronization efficacy in RVT group was significantly superior to that in RVA groyp (NYHA class decrease 1.2+-0.5 vs 0.7+-0.3, P<0.05; 6MWD increase 236.75+-39.6m vs 129.3+-53.8m, P<0.01; EF increase 12.6+-5.1% vs 7.3+-6.5%, P<0.01; BNP decrease 3756.3+-379.2u vs 2027.5+-493.2u, P<0.01; QRS width decrease 19.6+-6.1ms vs 13.5+-7.2ms, P<0.05).
Conclusions RVOT lead location is superior to RV apex in the improvement of cardiac resynchronizayion efficacy by matching posterio-lateral LV pacng