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Dual-site right ventricular pacing in patients undergoing cardiac resynchronization therapy: Results of a multicenter propensity-matched analysis.
Providencia, Rui; Barra, Sergio; Papageorgiou, Nikolaos; Ioannou, Adam; Rogers, Dominic; Wongwarawipat, Tanakal; Falconer, Debbie; Duehmke, Rudolf; Colicchia, Martina; Babu, Girish; Segal, Oliver R; Sporton, Simon; Dhinoja, Mehul; Ahsan, Syed; Ezzat, Vivienne; Rowland, Edward; Lowe, Martin; Lambiase, Pier D; Agarwal, Sharad; Chow, Anthony W.
Afiliación
  • Providencia R; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Barra S; Papworth Hospital NHS Foundation Trust, Cambridge, UK.
  • Papageorgiou N; The Heart Hospital, University College of London Hospitals NHS Trust, London, UK.
  • Ioannou A; The Heart Hospital, University College of London Hospitals NHS Trust, London, UK.
  • Rogers D; The Heart Hospital, University College of London Hospitals NHS Trust, London, UK.
  • Wongwarawipat T; The Heart Hospital, University College of London Hospitals NHS Trust, London, UK.
  • Falconer D; The Heart Hospital, University College of London Hospitals NHS Trust, London, UK.
  • Duehmke R; Papworth Hospital NHS Foundation Trust, Cambridge, UK.
  • Colicchia M; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Babu G; The Heart Hospital, University College of London Hospitals NHS Trust, London, UK.
  • Segal OR; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Sporton S; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Dhinoja M; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Ahsan S; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Ezzat V; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Rowland E; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Lowe M; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Lambiase PD; Barts Heart Centre, Barts Health NHS Trust, London, UK.
  • Agarwal S; Papworth Hospital NHS Foundation Trust, Cambridge, UK.
  • Chow AW; Barts Heart Centre, Barts Health NHS Trust, London, UK.
Pacing Clin Electrophysiol ; 40(10): 1113-1120, 2017 Oct.
Article en En | MEDLINE | ID: mdl-28734025
BACKGROUND: Dual-site right ventricular pacing (Dual RV) has been proposed as an alternative for patients with heart failure undergoing cardiac resynchronization therapy (CRT) with a failure to deliver a coronary sinus (CS) lead. Only short-term hemodynamic and echocardiographic results of Dual RV are available. We aimed to assess the long-term results of Dual RV and its impact on survival. METHODS: Multicenter retrospective assessment of all CRT implants during a 12-year period. Patients with failed CS lead implantation, treated with Dual RV, were followed and assessed for the primary endpoint of all-cause mortality and/or heart transplant. A control group was obtained from contemporary patients using propensity matching for all available baseline variables. RESULTS: Ninety-three patients were implanted with Dual RV devices and compared with 93 matched controls. During a median of 1,273 days (interquartile range 557-2,218), intention-to-treat analysis showed that all-cause mortality and/or heart transplant was higher in the Dual RV group (adjusted hazard ratio [HR] = 1.66, 95% confidence interval [CI] 1.12-2.47, P = 0.012). As-treated analysis yielded similar results (HR = 1.97, 95% CI 1.31-2.96, P = 0.001). Cardiac device-related infections occurred seven times more frequently in the Dual RV site group (HR = 7.60, 95% CI 1.51-38.33, P = 0.014). Among Dual RV nonresponders, four had their apical leads switched off, five required an epicardial LV lead insertion, a transseptal LV lead was implanted in two, and in nine patients, after reviewing the CS venogram, a new CS lead insertion was successfully attempted. CONCLUSION: Dual RV pacing is associated with worse clinical outcomes and higher complication rates than conventional CRT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Marcapaso Artificial / Desfibriladores Implantables / Puntaje de Propensión / Terapia de Resincronización Cardíaca / Insuficiencia Cardíaca Tipo de estudio: Observational_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Pacing Clin Electrophysiol Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos
Texto completo
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XML
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Marcapaso Artificial / Desfibriladores Implantables / Puntaje de Propensión / Terapia de Resincronización Cardíaca / Insuficiencia Cardíaca Tipo de estudio: Observational_studies Límite: Aged / Female / Humans / Male Idioma: En Revista: Pacing Clin Electrophysiol Año: 2017 Tipo del documento: Article Pais de publicación: Estados Unidos