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CRT Pacing: Midterm Follow-Up in LV Only Pacing without RV Lead in Patients with Normal AV Conduction
Background: The aim of our study was to assess the real life cardiac resynchronization therapy (CRT) fusion left ventricular (LV) only pacing in patients with normal AV conduction (NAVc) without right ventricular (RV) lead. Methods: Consecutive NAVc patients with CRT indication were implanted with a...
Autores principales: | , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306808/ https://www.ncbi.nlm.nih.gov/pubmed/30544823 http://dx.doi.org/10.3390/jcm7120531 |
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author | Cozma, Dragos Vacarescu, Cristina Petrescu, Lucian Mornos, Cristian Goanta, Emilia Feier, Horea Luca, Constantin Tudor Gusetu, Gabriel Vatasescu, Radu |
author_facet | Cozma, Dragos Vacarescu, Cristina Petrescu, Lucian Mornos, Cristian Goanta, Emilia Feier, Horea Luca, Constantin Tudor Gusetu, Gabriel Vatasescu, Radu |
author_sort | Cozma, Dragos |
collection | PubMed |
description | Background: The aim of our study was to assess the real life cardiac resynchronization therapy (CRT) fusion left ventricular (LV) only pacing in patients with normal AV conduction (NAVc) without right ventricular (RV) lead. Methods: Consecutive NAVc patients with CRT indication were implanted with a right atrium RA/LV DDD pacing system. Complete follow-up at 1, 3 and every 6 months thereafter included echocardiography and stress testing. Results: We analysed 55 patients (62 ± 11 years). All patients were responders with significant LV reverse remodelling (LV end-diastolic volume 193.7 ± 81 vs. 243.2 ± 82 mL at baseline, p < 0.002) and increased LV ejection fraction (38 ± 7.9% vs. 27 ± 5.2% at baseline, p < 0.001). Mitral regurgitation decreased in 38 patients (69%). During follow-up (35 ± 18 months), 20 patients (36%) needed reprogramming sensed/paced AV delay or maximum tracking rate (MTR) because of inadequate or lost LV capture at exercise test; personalized programming to achieve up to 100% fusion pacing was used in all patients. One patient developed Mobitz II second degree AV block and triple chamber CRT-P upgrade was performed; defibrillator upgrade was not necessary. Conclusions: LV only pacing CRT-P without RV lead showed a positive outcome in carefully selected patients. |
format | Online Article Text |
id | pubmed-6306808 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-63068082019-01-02 CRT Pacing: Midterm Follow-Up in LV Only Pacing without RV Lead in Patients with Normal AV Conduction Cozma, Dragos Vacarescu, Cristina Petrescu, Lucian Mornos, Cristian Goanta, Emilia Feier, Horea Luca, Constantin Tudor Gusetu, Gabriel Vatasescu, Radu J Clin Med Article Background: The aim of our study was to assess the real life cardiac resynchronization therapy (CRT) fusion left ventricular (LV) only pacing in patients with normal AV conduction (NAVc) without right ventricular (RV) lead. Methods: Consecutive NAVc patients with CRT indication were implanted with a right atrium RA/LV DDD pacing system. Complete follow-up at 1, 3 and every 6 months thereafter included echocardiography and stress testing. Results: We analysed 55 patients (62 ± 11 years). All patients were responders with significant LV reverse remodelling (LV end-diastolic volume 193.7 ± 81 vs. 243.2 ± 82 mL at baseline, p < 0.002) and increased LV ejection fraction (38 ± 7.9% vs. 27 ± 5.2% at baseline, p < 0.001). Mitral regurgitation decreased in 38 patients (69%). During follow-up (35 ± 18 months), 20 patients (36%) needed reprogramming sensed/paced AV delay or maximum tracking rate (MTR) because of inadequate or lost LV capture at exercise test; personalized programming to achieve up to 100% fusion pacing was used in all patients. One patient developed Mobitz II second degree AV block and triple chamber CRT-P upgrade was performed; defibrillator upgrade was not necessary. Conclusions: LV only pacing CRT-P without RV lead showed a positive outcome in carefully selected patients. MDPI 2018-12-08 /pmc/articles/PMC6306808/ /pubmed/30544823 http://dx.doi.org/10.3390/jcm7120531 Text en © 2018 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cozma, Dragos Vacarescu, Cristina Petrescu, Lucian Mornos, Cristian Goanta, Emilia Feier, Horea Luca, Constantin Tudor Gusetu, Gabriel Vatasescu, Radu CRT Pacing: Midterm Follow-Up in LV Only Pacing without RV Lead in Patients with Normal AV Conduction |
title | CRT Pacing: Midterm Follow-Up in LV Only Pacing without RV Lead in Patients with Normal AV Conduction |
title_full | CRT Pacing: Midterm Follow-Up in LV Only Pacing without RV Lead in Patients with Normal AV Conduction |
title_fullStr | CRT Pacing: Midterm Follow-Up in LV Only Pacing without RV Lead in Patients with Normal AV Conduction |
title_full_unstemmed | CRT Pacing: Midterm Follow-Up in LV Only Pacing without RV Lead in Patients with Normal AV Conduction |
title_short | CRT Pacing: Midterm Follow-Up in LV Only Pacing without RV Lead in Patients with Normal AV Conduction |
title_sort | crt pacing: midterm follow-up in lv only pacing without rv lead in patients with normal av conduction |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6306808/ https://www.ncbi.nlm.nih.gov/pubmed/30544823 http://dx.doi.org/10.3390/jcm7120531 |
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