OBJECTIVES: The purpose of this study was to study the acute hemodynamic effect of left ventricular (LV) stimulation sites within a coronary vein. BACKGROUND: Access to LV stimulation sites for resynchronization therapy is achieved using specialized lead systems navigated through a coronary vein. The effects of stimulation in different coronary veins have been evaluated previously, but less is known about stimulation sites within a coronary vein. METHODS:Twenty-four patients (New York Heart Association functional class II-IV, age 59 +/- 10 years, ejection fraction 21 +/- 7%, QRS 166 +/- 30 ms) were enrolled in the study. A novel over-the-wire lead system was used to access an anterior or lateral coronary vein. At each lead location, a randomized stimulation protocol was executed. Hemodynamic responses were evaluated using LV dP/dtmax. RESULTS: The mean time to cannulate the coronary sinus and position the LV lead was 19 +/- 30 minutes and 17 +/- 18 minutes, respectively. Data from stimulation at two sites within a coronary vein were obtained in 19 patients (anterior vein 11; lateral vein 8). Of these patients, 14 (anterior vein 9; lateral vein 5) showed large improvement in dP/dtmax (22%-25% in anterior vein, 37%-40% in lateral vein). Overall, there were no group differences in hemodynamic effects among different stimulation sites within a coronary vein, although significant variability among sites was observed in individuals. CONCLUSIONS:Resynchronization therapy through a coronary vein improves acute hemodynamic function of heart failure patients with LV conduction disorder. There were no significant differences between basal and apical pacing sites for this group.
RCT Entities:
OBJECTIVES: The purpose of this study was to study the acute hemodynamic effect of left ventricular (LV) stimulation sites within a coronary vein. BACKGROUND: Access to LV stimulation sites for resynchronization therapy is achieved using specialized lead systems navigated through a coronary vein. The effects of stimulation in different coronary veins have been evaluated previously, but less is known about stimulation sites within a coronary vein. METHODS: Twenty-four patients (New York Heart Association functional class II-IV, age 59 +/- 10 years, ejection fraction 21 +/- 7%, QRS 166 +/- 30 ms) were enrolled in the study. A novel over-the-wire lead system was used to access an anterior or lateral coronary vein. At each lead location, a randomized stimulation protocol was executed. Hemodynamic responses were evaluated using LV dP/dtmax. RESULTS: The mean time to cannulate the coronary sinus and position the LV lead was 19 +/- 30 minutes and 17 +/- 18 minutes, respectively. Data from stimulation at two sites within a coronary vein were obtained in 19 patients (anterior vein 11; lateral vein 8). Of these patients, 14 (anterior vein 9; lateral vein 5) showed large improvement in dP/dtmax (22%-25% in anterior vein, 37%-40% in lateral vein). Overall, there were no group differences in hemodynamic effects among different stimulation sites within a coronary vein, although significant variability among sites was observed in individuals. CONCLUSIONS: Resynchronization therapy through a coronary vein improves acute hemodynamic function of heart failurepatients with LV conduction disorder. There were no significant differences between basal and apical pacing sites for this group.
Authors: David Soto Iglesias; Nicolas Duchateau; Constantine Butakoff Kostantyn Butakov; David Andreu; Juan Fernandez-Armenta; Bart Bijnens; Antonio Berruezo; Marta Sitges; Oscar Camara Journal: IEEE J Transl Eng Health Med Date: 2016-12-16 Impact factor: 3.316
Authors: John Rickard; Christopher Ingelmo; Dan Sraow; Bruce L Wilkoff; Richard A Grimm; Paul Schoenhagen; Patrick J Tchou; Milind Y Desai Journal: J Interv Card Electrophysiol Date: 2011-05-17 Impact factor: 1.900
Authors: Prabhat Kumar; Gaurav A Upadhyay; Christine Cavaliere-Ogus; E Kevin Heist; Robert K Altman; Neal A Chatterjee; Kimberly A Parks; Jagmeet P Singh Journal: J Interv Card Electrophysiol Date: 2012-12-21 Impact factor: 1.900