CLINICAL STUDY: HEART FAILURE
Long-term left ventricular pacing: assessment and comparison with biventricular pacing in patients with severe congestive heart failure
Abdelkader Touiza, MDa,
Yves Etienne, MDa,
Martine Gilard, MDa,
Marjaneh Fatemi, MDa,
Jacques Mansourati, MDa and
Jean-Jacques Blanc, MD*,a
a Department of Cardiology, Brest University Hospital, Brest, France
Manuscript received January 12, 2001;
revised manuscript received April 16, 2001,
accepted August 22, 2001.
* Reprint requests and for correspondence: Dr. Jean-Jacques Blanc, Départment de Cardiologie, CHU de la Cavale Blanche, Bd Tanguy Prigent, 29 609, Brest Cedex (France)
Jean-Jacques.Blanc{at}univ-brest.fr
OBJECTIVE
The purpose of this study is to report prospectively the results of six-month follow-up of permanent left ventricular (LV) based pacing in patients with severe congestive heart failure (CHF) and left bundle branch block (LBBB).
BACKGROUND
Left ventricular pacing alone has been demonstrated to result in identical improvement compared to biventricular pacing (BiV) during acute hemodynamic evaluation in patients with advanced CHF and LBBB. However, to our knowledge, the clinical outcome during permanent LV pacing alone versus BiV pacing mode has not been evaluated.
METHODS
Pacing configuration (LV or BiV) was selected according to the physician’s preference. Patient evaluation was performed at baseline and at six months.
RESULTS
Thirty-three patients with advanced CHF and LBBB were included. Baseline characteristics of LV (18 patients) and BiV (15 patients) pacing groups were similar. During the six-month follow-up period, seven patients died three BiV and four LV). In the surviving patients at 6 months, 8 of 14 patients in the LV group and 9 of 12 in the BiV group were in New York Heart Association class I or II (p = 0.39). No significant difference was observed between the two groups in terms of objective parameters except for LV end-diastolic diameter decrease (–4.4 mm in BiV group vs. –0.7 mm in LV group; p = 0.04).
CONCLUSION
At six-month follow-up, a trend toward improvement was observed in objective parameters in patients with severe CHF and LBBB following LV-based pacing. The two pacing modes (LV and BiV) were associated with almost equivalent improvement of subjective and objective parameters.
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Abbreviations and Acronyms
| | AV | = atrioventricular | | BiV | = biventricular (pacing) | | CHF | = congestive heart failure | | LBBB | = left bundle branch block | | LV | = left ventricular (pacing) | | LVEDD | = left ventricular end-diastolic diameter | | LVEF | = left ventricular ejection fraction | | MR | = mitral regurgitation | | NYHA | = New York Heart Association | | PCWP | = pulmonary capillary wedge pressure | | RV | = right ventricular | | VO2 | = oxygen consumption |
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50(15):
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|
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|
|
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115(16):
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|
|
|
|
|
|
|
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92(12):
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[Full Text]
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|
|
|
|
|
|
|
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27(9):
1018 - 1025.
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|
|
|
|
|
|
|
M. J. Flynn, J. M. McComb, and J. H. Dark
Reply to fernandez et Al.
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April 1, 2006;
29(4):
634 - 634.
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|
|
|
|
|
|
|
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113(7):
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|
|
|
|
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Biventricular vs. left univentricular pacing in heart failure: rationale, design, and endpoints of the B-LEFT HF study.
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January 1, 2006;
8(1):
76 - 80.
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[Full Text]
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|
|
|
|
|
|
|
B. M. van Gelder, F. A. Bracke, A. Meijer, and N. H.J. Pijls
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December 20, 2005;
46(12):
2305 - 2310.
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|
|
|
|
|
|
|
M. J. Flynn, J. M. McComb, and J. H. Dark
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Eur. J. Cardiothorac. Surg.,
August 1, 2005;
28(2):
250 - 253.
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|
|
|
|
|
|
|
L. Faber, B. Lamp, J. Vogt, and D. Horstkotte
Tissue Doppler imaging in patients with congestive heart failure and conduction disorders
Eur. Heart J. Suppl.,
August 1, 2004;
6(suppl_D):
D10 - D15.
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[Full Text]
[PDF]
|
|
|
|
|
|
|
W. G. Stevenson and M. O. Sweeney
Single Site Left Ventricular Pacing for Cardiac Resynchronization
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April 13, 2004;
109(14):
1694 - 1696.
[Full Text]
[PDF]
|
|
|
|
|
|
|
J.-J. Blanc, V. Bertault-Valls, M. Fatemi, M. Gilard, P.-Y. Pennec, and Y. Etienne
Midterm Benefits of Left Univentricular Pacing in Patients With Congestive Heart Failure
Circulation,
April 13, 2004;
109(14):
1741 - 1744.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. Lafitte, S. Garrigue, J.-M. Perron, P. Bordachar, S. Reuter, P. Jais, M. Haissaguerre, J. Clementy, and R. Roudaut
Improvement of left ventricular wall synchronization with multisite ventricular pacing in heart failure: a prospective study using Doppler tissue imaging
Eur J Heart Fail,
March 1, 2004;
6(2):
203 - 212.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. T. Willerson and D. J. Kereiakes
Cardiac Resynchronization Therapy: Helpful Now in Selected Patients With CHF
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January 27, 2004;
109(3):
308 - 309.
[Full Text]
[PDF]
|
|
|
|
|
|
|
E. Puggioni, M. Brignole, M. Gammage, E. Soldati, M. G. Bongiorni, E. N. Simantirakis, P. Vardas, F. Gadler, L. Bergfeldt, C. Tomasi, et al.
Acute comparative effect of right and left ventricular pacing in patients with permanent atrial fibrillation
J. Am. Coll. Cardiol.,
January 21, 2004;
43(2):
234 - 238.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Auricchio, C. Stellbrink, C. Butter, S. Sack, J. Vogt, A. R. Misier, D. Bocker, M. Block, J. H. Kirkels, Pacing Therapies in Congestive Heart Failure (PATH, et al.
Clinical efficacy of cardiac resynchronization therapy using left ventricular pacing in heart failure patients stratified by severity of ventricular conduction delay
J. Am. Coll. Cardiol.,
December 17, 2003;
42(12):
2109 - 2116.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
D. A. Kass
Predicting cardiac resynchronization response by qrs duration: The long and short of it
J. Am. Coll. Cardiol.,
December 17, 2003;
42(12):
2125 - 2127.
[Full Text]
[PDF]
|
|
|
|
|
|
|
W. T. Abraham and D. L. Hayes
Cardiac Resynchronization Therapy for Heart Failure
Circulation,
November 25, 2003;
108(21):
2596 - 2603.
[Full Text]
[PDF]
|
|
|
|
|
|
|
O. P. Faris, F. J. Evans, A. J. Dick, V. K. Raman, D. B. Ennis, D. A. Kass, and E. R. McVeigh
Endocardial versus epicardial electrical synchrony during LV free-wall pacing
Am J Physiol Heart Circ Physiol,
November 1, 2003;
285(5):
H1864 - H1870.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. A. Morgan, M. E. Ginsburg, J. R. Sonett, D. L.S. Morales, T. Kohmoto, L. A. Gorenstein, C. R. Smith, and M. Argenziano
Advanced thoracoscopic procedures are facilitated by computer-aided robotic technology
Eur. J. Cardiothorac. Surg.,
June 1, 2003;
23(6):
883 - 887.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Jessup and S. Brozena
Heart Failure
N. Engl. J. Med.,
May 15, 2003;
348(20):
2007 - 2018.
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. Fauchier, O. Marie, D. Casset-Senon, D. Babuty, P. Cosnay, and J. P. Fauchier
Interventricular and intraventricular dyssynchrony in idiopathic dilated cardiomyopathy: A prognostic study with fourier phase analysis of radionuclide angioscintigraphy
J. Am. Coll. Cardiol.,
December 4, 2002;
40(11):
2022 - 2030.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. Brignole
A novel use of cardiac pacing to improve cardiac function, quality of life and (hopefully) survival in patients with heart failure and permanent atrial fibrillation
Eur. Heart J.,
November 2, 2002;
23(22):
1732 - 1736.
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Leclercq, O. Faris, R. Tunin, J. Johnson, R. Kato, F. Evans, J. Spinelli, H. Halperin, E. McVeigh, and D. A. Kass
Systolic Improvement and Mechanical Resynchronization Does Not Require Electrical Synchrony in the Dilated Failing Heart With Left Bundle-Branch Block
Circulation,
October 1, 2002;
106(14):
1760 - 1763.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
L. A. Saxon and T. De Marco
Cardiac resynchronization: a cornerstone in the foundation of device therapy for heart failure
J. Am. Coll. Cardiol.,
December 1, 2001;
38(7):
1971 - 1973.
[Full Text]
[PDF]
|
|
|
|
