Journal Article

P.2. Syncope, Pacemaker, CRT & ICD

L. Sciarra, G. Paparella, M. Bocchino, G. Pastore, E. Marras, D. Milan, E. Moro, C. Marcon, P. Delise and R. Cazzin

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 7, issue s3, pages S45-S45
Published in print October 2005 | ISSN: 1099-5129
Published online October 2005 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1016/j.eupc.2005.08.188
P.2. Syncope, Pacemaker, CRT & ICD

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Patients with permanent right ventricular apical pacing may develop interventricular and intraventricular dyssynchrony as a consequence of the pacing-induced “LBBB-like” ventricular activation. Aim of the study: to compare the effects of cardiac resynchronization therapy (CRT) in pts with spontaneous LBBB and with PILBBB.

Methods

68 pts with severe HF (EF < 0.35; NYHA class ≥ 3) (73±7 yrs; 63 m) underwent to biventricular pacing. Pts were divided in 2 groups: LBBB (49 pts; 71±8 yrs; 39 m) and PILBBB (29 pts; 75±6 yrs; 24 m). Clinical, echocardiographic and ECG data were collected at baseline and post implant: mean follow-up (fu): 11±7 months.

Results

In both groups, CRT induced significative decrease of NYHA class (LBBB: 3.4±0.5 vs 2.1±0.8 in the fu; p<0.01) (PILBBB: 3.4±0.5 vs 2.1±0.7 at fu; p<0.01), an improvement of the quality of life (QOL), as confirmed by the decrease of the Minnesota QOL questionnaire (LBBB: 60±24 vs 45±28 at fu; p<0) (PILBBB: 71±25 vs 43±21 at fu; p=0.03), an increasing of the EF (LBBB 0.27±0.06 vs 0.34±0.09 at fu; p<0.01) (PILBBB 0.24±0.07 vs 0.34±0.09 at fu; p<0.01) and a significative reduction of the QRS duration (LBBB 178±27 ms vs 149±25 ms at fu; p<0.01)(PILBB193±27 ms vs 144±23 ms at fu; p<0.01). All the differences, both at baseline and during the follow-up, were not statistically significant.

Conclusions

Patients with advanced HF and mechanical dissyncrony secondary to PILBBB show similar improvement in symptoms and cardiac performance compared to pts with LBBB, so they can be considered as good candidates to upgrading to biventricular pacing.

Journal Article.  0 words. 

Subjects: Cardiovascular Medicine

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