Dijk, G. van (Gerben) (2014) Lange termijn prestaties van de linker ventrikel lead bij patiënten met cardiac resynchronization therapy: invloed van de anatomische positie op echocardiografische en klinische uitkomsten. thesis, Medicine.
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Abstract
Background: Cardiac Resynchronization Therapy CRT is an effective treatment for patients with severe heart failure. The position of the left ventricular (LV) lead is a determinant of successful treatment, a posterolateral position is preferred. The aim of the study was to analyze the lifetime of the LV-leads and the impact of the position on echocardiographic and clinical outcomes. Method: The LV-lead location was assessed by means of coronary venograms, made during implantation, and chest X-rays. Along the short axis view a lateral, posterolateral or lateral LV-lead position was classified as concordant and anterior, anterolateral, or mid-cardiac vein as discordant. Along the long axis view a basal or mid-LVlead position was classified as concordant and apical discordant. Endpoints were: increase of ejection fraction, heart failure hospitalization and all-cause mortality. Results: 434 patients were included (age 67 year ±1,9 , 71% men, 53% ischemic heart failure with a clinical follow-up of 5,3 year ±1,9). In these patients, 438 LV-leads were implanted with a follow-up of 4,77 year ±2,25. During this follow-up there was a complication rate of 10.8% which required reimplantation of the LV-lead. Increase in ejection fraction was higher in the group with a concordant LV-lead position (5%) compared to the group with a discordant position (P=0,040). A concordant LV-lead position showed a trend towards better survival. The long axis LV-lead position was indifferent. Conclusion: A lateral, posterolateral or posterior LV-lead position leads to a higher increase of ejection fraction. This LV-lead position shows a trend towards better survival..The long term failure rate of the LV-lead was 10,8%.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Ghani, A. |
| Supervisor name: | Ramdat Misier, dr. A.R. and Afdeling cardiologie and Isalaklinieken te Zwolle |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:47 |
| Last Modified: | 25 Jun 2020 10:47 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/807 |
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