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Totally epicardial cardiac resynchronization therapy system implantation in patients with heart failure undergoing CABG
Author(s) -
GoscinskaBis Kinga,
Bis Jaroslaw,
Krejca Michal,
Ulczok Rafal,
Szmagala Przemyslaw,
Bochenek Andrzej,
Kargul Wlodzimierz
Publication year - 2008
Publication title -
european journal of heart failure
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 5.149
H-Index - 133
eISSN - 1879-0844
pISSN - 1388-9842
DOI - 10.1016/j.ejheart.2008.03.007
Subject(s) - medicine , cardiac resynchronization therapy , cardiology , heart failure , ejection fraction
Background: Systolic dyssynchrony is present in a considerable number of patients with heart failure (HF) undergoing coronary artery bypass grafting (CABG). Surgical revascularization offers an optimal setting for totally epicardial cardiac resynchronization therapy (CRT) system implantation. Aim: To assess the efficacy of totally epicardial CRT implantation during CABG, in patients with HF. Methods: Twenty three patients with HF and dyssynchrony underwent totally epicardial CRT system implantation during CABG. This randomised, single‐blind, cross‐over study compared clinical and echocardiographic parameters during two periods: 3 months of active CRT (CRT+) and 3 months of inactive CRT (CRT−) pacing. Results: Twenty two patients underwent randomisation and completed both study periods. In the CRT+ group more patients improved by two NYHA classes ( p =0.028), had a longer 6‐minute walk test distance ( p =0.047) and better quality of life ( p =0.003) compared with the CRT− group. Echocardiography revealed an improved LV ejection fraction ( p <0.001), smaller LV end‐systolic volume ( p =0.04), reduced mitral regurgitation ( p =0.026) and improved LV synchrony in the CRT+ group compared with the CRT− group. Conclusion: CRT delivered by a totally epicardial system implanted during CABG is associated with additional improvement of clinical and echocardiographic parameters in patients with HF and systolic dyssynchrony.