Med Biol Eng Comput - Transesophageal left ventricular electrogram-recording and temporary pacing to improve patient selection for cardiac resynchronization.

Tópicos

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Resumo

Cardiac resynchronization therapy (CRT) with biventricular pacing (BV) is an established therapy for heart failure (HF) patients with inter- and intraventricular conduction delay. The aim of this pilot study was to test the feasibility of both transesophageal measurement of left ventricular (LV) electrical delay and transesophageal LV pacing prior to implantation, to better select patients for CRT. Esophageal TO8 Osypka catheter was perorally applied in 30 HF patients in position of maximum LV deflection to measure LV electrical delay and to study arterial pulse pressure (PP) during transesophageal bipolar LV pacing. There were 15 responders with a PP increase of a mean 65 ? 24 mmHg to 79 ? 27 mmHg (P < 0.001) and a mean LV electrical delay of 86.8 ? 33 ms. The 15 non-responders with poor PP increase of a mean 63.5 ? 23.5 mmHg to 64.1 ? 23.9 mmHg (P = 0.065) had a significantly smaller LV electrical delay of 36 ? 21 ms (P < 0.001). During a 34 ? 26 month CRT follow-up, the responders New York Heart Association (NYHA) class improved from 3.1 ? 0.35 to 2.1 ? 0.35 (P < 0.001). Determination of left ventricular electrical delay by transesophageal electrogram recording and transesophageal left ventricular pacing may be additional useful techniques to improve patient selection for CRT.

Resumo Limpo

cardiac resynchron therapi crt biventricular pace bv establish therapi heart failur hf patient inter intraventricular conduct delay aim pilot studi test feasibl transesophag measur left ventricular lv electr delay transesophag lv pace prior implant better select patient crt esophag osypka cathet peror appli hf patient posit maximum lv deflect measur lv electr delay studi arteri puls pressur pp transesophag bipolar lv pace respond pp increas mean mmhg mmhg p mean lv electr delay ms nonrespond poor pp increas mean mmhg mmhg p signific smaller lv electr delay ms p month crt followup respond new york heart associ nyha class improv p determin left ventricular electr delay transesophag electrogram record transesophag left ventricular pace may addit use techniqu improv patient select crt

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