Different Response to Cardiac Resynchronization Therapy by QRS Duration in the Patients with Chronic Right Ventricular Pacing
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概要
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<B>Background:</B> Effect of upgrade from permanent right ventricular (RV) apical pacing to biventricular (BiV) pacing has not yet delineated. <B>Aims:</B> The aim of this study is to investigate the role of upgrade from RV pacing to BiV pacing. <B>Methods:</B> Sixty four patients with NYHA>class 2 heart failure and LV ejection fraction (LVEF)<35% were divided into two groups: Group-A (primary BiV pacing in 40 patients with intrinsic QRS>130 msec) and group-B (upgrade to BiV pacing in 24 patients with bradycardia and paced-QRS>150 msec). The LV volume and systolic function were assessed with echocardiography at baseline and 6 months after implantation of a cardiac resynchronization (CRT) device. A reduction in LV end systolic volume (LVESV)>15% was defined as responder. <B>Results:</B> LVESV reduced significantly in group-A (204.7 ml to 181.6 ml, P<0.05) and in group-B (152.6 ml to 124.4 ml, P<0.05). Additionally, the reduction in LVESV showed positive correlation with paced-QRS duration at baseline (r=0.46, P<0.05) in group-B. Responder rate was not different in both groups (50.5% vs. 62.5%, P=0.23). <B>Conclusion:</B> CRT upgrade from chronic RV apical pacing is also effective especially in patients with wider QRS duration.
著者
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Yagishita Daigo
Department Of Cardiology Osaka City General Hospital
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Ejima Koichiro
Department Of Cardiology Tokyo Women's Medical University
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Yashiro Bun
Department Of Cardiology Tokyo Women's Medical University
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Shoda Morio
Department Of Cardiology The Cardiovascular Center Of Sendai
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Hagiwara Nobuhisa
Department Of Cardiology Heart Institute Of Japan Tokyo Women's Medical University
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Manaka Tetsuyuki
Department Of Cardiology Tokyo Women's Medical University
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Wakisaka Osamu
Department Of Internal Medicine 1 Faculty Of Medicine Oita Univercity
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Hagiwara Nobuhisa
Department of Cardiology, Tokyo Women's Medical University
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Wakisaka Osamu
Department of Cardiology, Tokyo Women's Medical University
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