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Influence of Left Ventricular Lead Location on Outcomes in the COMPANION Study
Author(s) -
SAXON LESLIE A.,
OLSHANSKY BRIAN,
VOLOSIN KENT,
STEINBERG JONATHAN S.,
LEE BYRON K.,
TOMASSONI GERY,
GUARNIERI THOMAS,
RAO ANUPAMA,
YONG PATRICK,
GALLE ELIZABETH,
LEIGH JILL,
ECKLUND FRED,
BRISTOW MICHAEL R.
Publication year - 2009
Publication title -
journal of cardiovascular electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.193
H-Index - 138
eISSN - 1540-8167
pISSN - 1045-3873
DOI - 10.1111/j.1540-8167.2009.01444.x
Subject(s) - medicine , cardiac resynchronization therapy , lead (geology) , cardiology , randomized controlled trial , quality of life (healthcare) , heart failure , ejection fraction , nursing , geomorphology , geology
There are no randomized controlled trial data that evaluate mortality and hospitalization rates in cardiac resynchronization therapy (CRT) recipients based on left ventricular (LV) lead location. We analyzed the event‐driven outcomes of mortality and hospitalization as well as functional outcomes including Functional Class, Quality‐of‐Life, and 6‐minute walk distance in 1,520 patients enrolled in the COMPANION study of CRT versus optimal medical therapy.Methods and Results:Over a mean follow‐up after implantation of 16.2 months, patients randomized to CRT, regardless of lead location, experienced benefit compared with optimized pharmacologic therapy (OPT), with respect to all‐cause mortality or heart failure hospitalization. All but a posterior location showed benefit with respect to the all‐cause mortality or all‐cause hospitalization outcome. Mortality benefit in CRT‐D patients was indifferent to LV lead position. All functional outcomes including 6‐minute walk distance, Quality‐of‐Life (QOL) and Functional Class improved with CRT, regardless of LV lead location.Conclusion:LV lead location was not a major determinant of multiple measures of response to CRT therapy in the COMPANION Trial. While acute data indicate that a left lateral LV lead location results in the most favorable hemodynamic response, these chronic data suggest that positioning an LV lead in an anterior rather than a lateral or posterior LV location has similar benefit.